Medical Students Explore End of Life Issues in Small Town Settings

02-09-2017 14:35

Medical schools have begun to insert end-of-life lessons into their required curriculum to meet accreditation standards for teaching palliative care. Schillerstrom, Sanchez-Reilly, and O’Donnell (2012) reported on one learning activity in which first-year medical students were paired with an interdisciplinary team of providers, alongside a family member of a recently-deceased hospice patient, to discuss end-of-life issues from the various perspectives. Post-activity evidence from the facilitated discussions suggests students had a higher level of comfort and knowledge of end-of-life issues based on the course activity. A number of additional studies examine medical students’ experiences with the death of patients for whom they cared, focusing mostly on students’ emotional responses, and the varying amounts of support they receive from faculty preceptors (Smith-Han, et al 2016). It is clear that medical students are expected to have a basic understanding of the issues surrounding end-of-life care, and there are curriculum options to satisfy this expectation. However, some evidence suggests that medical students are not always provided appropriate role models to exemplify best practices in end-of-life instruction (Smith-Han, et al 2016). The goal of our activity was to build on existing curriculum for end-of-life instruction by introducing third-year medical students to end-of-life and hospice care in small town, community-based settings. A single physician facilitated the course activity and mentored students throughout the process. Medical students were expected to: 1) read Atul Gawande’s Being Mortal; 2) conduct a facilitated interview with their family medicine community preceptor to better understand the community agencies, services, and referral practices involved with patient care; 3) identify and visit a care setting in their respective small town communities; and 4) write summaries of their findings. Students completed a pre- and post- survey asking about their comfort levels: managing end-of-life symptoms, prognostication, and specific policies, definitions and qualifications related to hospice and palliative care. In this session, we offer the details of our lesson plan on an end-of-life teaching activity, and data on students’ experiences of the activity.

Author(s):Carrie A. Roseamelia, PhD
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