Care of the dying: a qualitative exploration of Foundation Year doctors’ experiences

Abstract

Areas for improvement were identified around all five main themes. These will be useful for informing those involved in undergraduate and foundation training on how to improve the experiences of Foundation Year doctors and thereby improve patient care.

Education and Training: Perceived educational impact, ­challenges and opportunities of hospice placements for foundation year doctors: a qualitative study

“…5,6,7,9 The limitations of providing palliative care in hospital settings, with dying patients being missed on ward rounds and given aggressive treatments have also been previously reported. 5,13 All participants felt that their hospice placement had or would change their practice, mainly through acquisition of transferable skills such as communication skills, improved recognition of dying and management of symptoms, findings in keeping with previous research. 17 Only one participant believed that palliative care skills were not required in his current specialty (general surgery -in which other studies have shown palliative care can be sub-optimal).…”

“…For example, communication skills have been acknowledged as a predominant learning need for junior doctors along with recognition and symptom control of dying patients. 13 Gaps in education and experience in both communication skills and palliative care have also been recognised previously, and other study participants have described being afraid of talking to dying patients and not knowing how to care for them. 5,6,7,9 The limitations of providing palliative care in hospital settings, with dying patients being missed on ward rounds and given aggressive treatments have also been previously reported.…”

“…10 F1s can find communication about end-of-life decisions and recognition of the dying phase challenging and can also lack knowledge of cancer care and symptoms. 11,12,13 There is a perceived lack of senior medical support when caring for dying patients in hospital placements. 12,14 However, support from other team members, in particular nursing teams and senior doctors, can significantly enhance learning environments.…”

Harmony or dissonance? The affordances of palliative care learning for emerging professional identity

“…Palliative care requires a patient-centered holistic approach encompassing biomedical competence and compassionate caring. The domain of palliative care can be emotionally evocative and a cultural shift away from the disease-based, curative model that may challenge how learners see themselves as emerging practitioners [7,[17][18][19][20][21][22][23][24][25][26]. In most published literature on palliative care education, learning is considered as individualistic, following the acquisition metaphor.…”

How can training in care of the dying be improved?

“…We found that FYs' experiences are variable and, within the five priorities, 5 good practice and areas for improvement exist. 6 In this paper we present the primary data analysis related to question three.…”