Chung Sang Tse1, Laura J Morrison2, Matthew S Ellman3. 1. 1 Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA. 2. 2 Yale Palliative Care Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA. 3. 3 Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
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.
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.
Authors: Kan Yin Wong; Wai Tak Victor Li; Pui Yu Yiu; Tsz Kiu Tong; On Hang Ching; Lok Yin Leung; Tsz Yau Cheung; Sze Chai Chan; Hoi Ying Law; Cheuk Hei Cheng Journal: Med Sci Educ Date: 2020-02-03