Learning to care for the dying: a survey of medical schools and a model course.

Education on death and dying is relatively new in the United States; a recent survey indicated that there is little consensus on teaching methods and content of courses. This paper reports the authors' 1989 survey of 111 U.S. medical schools, and describes a death and dying seminar offered at the Yale School of Medicine using patients as teachers. Regarding the survey, the authors mailed questionnaires to 124 schools; 111 responded. Twelve of the schools (11%) provided no formal teaching in death and dying. Of the 99 schools that did, 30 provided one or two lectures in the first two years. Fifty-one schools taught death and dying as a module of a larger required course, and 18 schools offered an elective. Lecture was the predominant teaching method, and patient participation was usually restricted to a class presentation. Regarding the Yale seminar, each student meets individually with a patient during the semester and in small groups with the instructor to discuss the interviews, personal reactions, and professional issues in the care of his or her patient-teacher. This seminar enables students to learn the personal effects of serious illness, coping techniques used in daily living, characteristics of the caring physician, and skills needed to provide compassionate care.