This paper is only available as a PDF. To read, Please Download here.
Abstract
Background. Although there has been a dramatic increase in education about death and dying in
medical school curricula, the physician's interaction with terminally ill patients
and their families still causes concern. The purpose of our study was to determine
the impact of the third-year clerkship on education of medical students about death
and dying.
Methods. From August 1, 1988, to August 1, 1990, a questionnaire concerning the care of terminally
ill patients was distributed to all students completing the third-year clinical clerkship
at our medical school.
Results. One hundred and eighty questionnaires were distributed, of which 106 were returned,
yielding a response rate of 59%. All students had cared for a terminally ill patient
during their third year. Forty-four (41%) students responding had never been present
when an attending physician talked with a dying patient, and 37 (35%) had never discussed
with an attending physician how to deal with a terminally ill patient. During the
surgical clerkship 77 (73%) students had never been present when a surgeon had to
tell the family of a patient bad news after surgery, and 90 (85%) had never been present
when an attending surgeon had informed a family that their relative had died. Despite
the fact that the curriculum addresses the stages of death and dying, almost half
of the students could not remember these. When they were discharging a terminally
ill patient home, one third of students could not identify problems that would be
encountered by the family in caring for the patient.
Conclusions. Fifty-seven (54%) felt that they were poorly equipped to deal with terminally ill
patients on graduation from medical school, and 91% welcomed the opportunity to be
educated in this area during the clinical years.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Teaching third-year medical students how to care for terminally ill patients.Acad Med. 1989; 64: 413-414
- Learning to care for the dying: a survey of medical schools and a model course.Acad Med. 1991; 66: 35-38
- How successful is teaching on terminal care?.Med Educ. 1986; 20: 342-348
- Death education in U.S. medical schools: 1975–1980.J Med Educ. 1981; 56: 111-114
- A clinical course on death and dying for medical students.J Med Educ. 1975; 50: 630-632
- Physician attitudes and practices at the time of patient death.Arch Intern Med. 1984; 144: 2389-2391
- Interns' attitudes towards aspects of their medical education.S Afr Med J. 1979; 56: 805-807
- Dying in hospital: the residents' viewpoint.Br Med J. 1982; 285: 712-714
- On death and dying.in: Macmillan Publishing Co, Inc, New York1970: 1-289
- Terminally ill patients: assessment of physician attitudes within teaching institution.NY State J Med. 1980; 80: 200-207
- What to tell cancer patients: a study of medical attitudes.JAMA. 1961; 175: 1120-1125
- The gynecologist and the dying cancer patient.Am J Obstet Gynecol. 1982; 144: 154-161
- The effectiveness of a short curriculum unit in death education for dietetic students.J Am Diet Assoc. 1988; 1: 26-28
- The influence of a lecture course in loss and grief on medical students: an empirical study of attitude formation.Med Educ. 1979; 13: 117-128
- A proposed model to teach medical students the care of the dying patient.J Med Educ. 1972; 45: 564-567
- The hospitalization of death: should more people die at home?.J Med Ethics. 1983; 9: 158-161
- Care of the dying in general practice.Br Med J. 1985; 291: 179-181
Article info
Publication history
Accepted:
October 24,
1991
Identification
Copyright
© 1993 Published by Elsevier Inc.
