“This is just too awful; I just can’t believe I experienced that …”: Medical Students’ Reactions to Their “Most Memorable” Patient Death

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PurposeTo examine medical students’ emotional reactions to their ”most memorable” patient death and the support they receive.MethodIn 2000–01, 65 third-year medical students at two Northeastern U.S. medical schools were randomly selected to participate in 60–90-minute interviews of open-ended and structured questions and a written questionnaire (using a ten-point scale) about their “most memorable” patient death. Independent reviewers coded each interview to identify the analytical categories. Descriptive data were generated from the written questionnaire.ResultsA total of 32 interviews were used in the analysis. Twelve (38%) students were in contact with the patient for less than 24 hours and 23 (73%) were not at all or minimally close to the patient (0–3 on ten-point scale). Sixteen of 28 students (57%) rated the impact of the death as highly emotionally powerful (7–10 on ten-point scale). The finality of deaths, particularly sudden deaths, evoked strong emotions. Four of 16 (25%) students who found the death highly emotionally powerful rated the amount of support from supervisors as extremely inadequate (0–3 on ten-point scale). There was no discussion of the death in 17 (63%) of the 27 cases in which the patient was cared for by the student’s team. Students perceived from supervising physicians that death and emotions are negative aspects of medicine.ConclusionsMedical students experienced patient deaths as emotionally powerful even when they were not close to the patients. Debriefing sessions with students were rare, and many students felt inadequately supported. Thus, a unique opportunity to teach about death, emotions and coping with stress is often lost.

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