MEDICAL STUDENTS’ EXPERIENCES WITH DYING PATIENTS: IDENTIFYING EDUCATIONAL NEEDS IN THE EASTERN CONTEXT

https://doi.org/10.22146/jpki.80697

I Made Pramana Dharmatika(1*), Yoyo Suhoyo(2), Titi Savitri Prihatiningsih(3)

(1) Master in Health Professions Education, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada
(2) Medical Education and Bioethics Department, Universitas Gadjah Mada
(3) Medical Education and Bioethics Department, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Background: The death of a patient is an event that could trigger medical students’ emotional reactions during clinical rotation. This study aimed to identify medical students’ preparedness in dealing with patients’ death and their educational needs through their lived experience.

Methods: This was a qualitative study with a descriptive phenomenological approach. Purposive sampling was used to select medical students with experience caring for dying patients during clinical rotation. Data were collected through semi-structured interviews. Colaizzi’s method was used to analyze data.

Results: The experience of six medical students showed medical students’ difficulties in discussing end-of-life with family members, giving emotional support to dying patients, and supporting grieving family members. Hierarchies and hidden curriculums influenced the interaction between medical students and medical staff during end-of-life care provision. The educational needs of medical students were teaching and learning about communication skills and attitudes in caring for dying patients, awareness of local culture in end-of-life care, the opportunity to observe medical staff communicate with dying patients and family members, and debriefing with healthcare team members after patients’ death.

Conclusion: The findings of this study have provided insight into medical students’ experiences in dealing with patients’ death and their problems. Medical schools should prepare medical students to care for dying patients through curriculum development.

 

 

 


Keywords


medical student, undergraduate, death and dying, end-of-life care, need assessment

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References

  1. Jones R, Finlay F. Medical students’ experiences and perception of support following the death of a patient in the UK, and while overseas during their elective period. Postgraduate Medical Journal. 2014;90(1060): 69–74. https://doi.org/10.1136/postgradmedj-2012-131474
  2. Pessagno R, Foote CE, Aponte R. Dealing with death: Medical students’ experiences with patient loss. OMEGA - Journal of Death and Dying. 2014;68(3): 207–228. https://doi.org/10.2190/OM.68.3.b
  3. Ratanawongsa N, Teherani A, Hauer KE. Third-year medical students’ experiences with dying patients during the internal medicine clerkship: A qualitative study of the informal curriculum. Academic Medicine. 2005;80(7): 641–647. https://doi.org/10.1097/00001888-200507000-00006
  4. Smith-Han K, Martyn H, Barrett A, Nicholson H. “That’s not what you expect to do as a doctor, you know, you don’t expect your patients to die.” Death as a learning experience for undergraduate medical students. BMC Medical Education. 2016;16(1): 1-8. https://doi.org/10.1186/s12909-016-0631-3
  5. Trivate T, Dennis AA, Sholl S, Wilkinson T. Learning and coping through reflection: exploring patient death experiences of medical students. BMC Medical Education. 2019;19(1): 1-15. https://doi.org/10.1186/s12909-019-1871-9
  6. Wells G, Youssef E, Winter R, Wright J, Llewellyn C. Medical student confidence in care of the dying and their family: a systematic review. BMJ Supportive & Palliative Care. 2021;11(3):233-241. https://doi.org/10.1136/bmjspcare-2019-001977
  7. Bansal A, Monk A, Norman M, Fingas S. Improving medical students’ confidence in end‐of‐life consultations. The Clinical Teacher. 2020;17(6): 705–710. https://doi.org/10.1111/tct.13214
  8. Boland JW, Dikomitis L, Gadoud A. Medical students writing on death, dying and palliative care: A qualitative analysis of reflective essays. BMJ Supportive & Palliative Care. 2016;6(4): 486–492. https://doi.org/10.1136/bmjspcare-2016-001110
  9. Raniolo G, O’Keeffe C, Omrani OA. Transparency about death: students on COVID-19. The Clinical Teacher. 2020;17(4):447–449. https://doi.org/10.1111/TCT.13227
  10. Monrouxe LV, Chandratilake M, Chen J, Chhabra S, Zheng L, Costa PS, Lee YM, Karnieli-Miller O, Nishigori H, Ogden K, Pawlikowska T, Riquelme A, Sethi A, Soemantri D, Wearn A, Wolvaardt L, Yusoff MSB, Yau SY. Medical Students’ and Trainees’ Country-By-Gender Profiles: Hofstede’s Cultural Dimensions Across Sixteen Diverse Countries. Frontiers in Medicine. 2022;8:2942. https://doi.org/10.3389/FMED.2021.746288/BIBTEX
  11. Hofstede G, Hofstede GJ, Minkov M. Cultures and Organizations: Software of the Mind: Intercultural Cooperation and its Importance for Survival. New York: McGraw-Hill; 2010.
  12. Muhaimin A, Good M-JD, Soenarto Y, Padmawati RS. Communication Barriers among Physicians in Care at the End of Life: Experience from a Postgraduate Residency Training in Java, Indonesia. Asian Bioethics Review. 2012;4(2): 102-114. https://muse.jhu.edu/article/478834
  13. Suhoyo Y, Schönrock-Adema J, Emilia O, Kuks JBM, Cohen-Schotanus J.. Clinical workplace learning: Perceived learning value of individual and group feedback in a collectivistic culture. BMC Medical Education. 2018;18(1): 1–6. https://doi.org/10.1186/S12909-018-1188-0/TABLES/1
  14. Putranto R, Mudjaddid E, Shatri H, Adli M, Martina D. Development and challenges of palliative care in Indonesia: Role of psychosomatic medicine. BioPsychoSocial Medicine. 2017;11(1): 1–5. https://doi.org/10.1186/s13030-017-0114-8
  15. Rochmawati E, Wiechula R, Cameron K. Current status of palliative care services in Indonesia: A literature review. International Nursing Review. 2016;63(2): 180–190.
  16. Neubauer BE, Witkop CT, Varpio L. How phenomenology can help us learn from the experiences of others. Perspectives on Medical Education. 2019;8(2): 90–97. https://doi.org/10.1007/s40037-019-0509-2
  17. Thomas PA, Kern DE, Hughes MT, Chen BY. Curriculum development for medical education: A six-step approach. Baltimore: Johns Hopkins University Press; 2015.
  18. Sanders C. Application of Colaizzi’s method: Interpretation of an auditable decision trail by a novice researcher. Contemporary Nurse: A Journal for the Australian Nursing Profession. 2003;14(3):292–302. https://doi.org/10.5172/conu.14.3.292
  19. Wirihana L, Welch A, Williamson M, Christensen M, Bakon S, Craft J. Using Colaizzi’s method of data analysis to explore the experiences of nurse academics teaching on satellite campuses. Nurse Researcher. 2018;25(4): 30–34. https://doi.org/10.7748/nr.2018.e1516
  20. Redman M, Pearce J, Gajebasia S, Johnson M, Finn G. Care of the dying: A qualitative exploration of Foundation Year doctors’ experiences. Medical Education. 2017;51(10): 1025–1036. https://doi.org/10.1111/medu.13358
  21. Ibrahim H, Lootah S, Satish KP, Harhara T. Medical student experiences and perceptions of palliative care in a middle eastern country. BMC Medical Education. 2022;22(1): 1–8. https://doi.org/10.1186/S12909-022-03448-X
  22. Doulougeri K, Panagopoulou E, Montgomery A. (How) do medical students regulate their emotions? BMC Medical Education. 2016;16(1): 1–10. https://doi.org/10.1186/S12909-016-0832-9/TABLES/5
  23. Kelly E, Nisker J. Medical students’ first clinical experiences of death. Medical Education. 2010;44(4): 421–428. https://doi.org/10.1111/j.1365-2923.2009.03603.x
  24. Palaganas JC, Charnetski M, Dowell S, Chan AKM, Leighton K. Cultural considerations in debriefing: A systematic review of the literature. BMJ Simulation & Technology Enhanced Learning. 2021;7(6): 605–610. https://doi.org/10.1136/bmjstel-2020-000857
  25. Rochmawati E, Wiechula R, Cameron K. Centrality of spirituality/religion in the culture of palliative care service in Indonesia: An ethnographic study. Nursing & Health Sciences. 2018;20(2): 231–237. https://doi.org/10.1111/NHS.12407
  26. Effendy C. The quality of palliative care for patients with cancer in Indonesia. (Doctoral dissertation); 2015. https://hdl.handle.net/2066/135629



DOI: https://doi.org/10.22146/jpki.80697

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