Preclinical Medical Students’ Diverse Educational and Emotional Responses to a Required Hospice Experience

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Abstract

Background:

Physicians’ lack of comfort and skill in communicating about hospice care results in deficits and delays in hospice referrals. Preclinical exposure to hospice may lay a foundation to improve medical students’ knowledge and comfort with hospice care.

Objective:

To understand how preclinical medical student (MS)-2s respond both educationally and emotionally to a required hospice care experience (HCE).

Design:

Accompanied by hospice clinicians, MS-2s spent 3 hours seeing inpatient or home hospice patients followed by a 1-hour debriefing. Students submitted written reflections to e-mailed educational and emotional prompts.

Setting/patients:

Two hundred and two MS-2s from 2 academic cohorts completed the HCE at 1 of 2 hospice sites.

Measurements:

Written reflective responses were analyzed qualitatively, where salient themes extracted and responses were coded.

Results:

Ninety-two students submitted 175 responses to Prompt #1 (educational impact) and 85 students entered 85 responses to prompt #2 (emotional impact) of the HCE. Eleven themes were identified for prompt #1, most frequently focusing on hospice services and goals and hospice providers’ attitudes and skills. Prompt #2 elicited a diverse spectrum of emotional responses, spanning positive and negative emotions. Most often, students reported “no specified emotional reaction,” “sad/depressed,” “difficult /challenging,” “heartened/encouraged,” and “mixed emotions.”

Conclusion:

In an HCE, preclinical students reported learning core aspects of hospice care and experiencing a broad spectrum of emotional responses. These findings may assist educators in the planning of HCEs for preclinical students, including debriefing sessions with skilled clinicians and opportunities for triggered reflection.

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