Students’ Experiences With Death and Dying Prior to Medical School: A Content Analysis of Students’ Written Reflections

Abstract

Background: Personal experiences with death and dying are common among medical students, but little is known about student attitudes and emotional responses to these experiences. Our objectives were to ascertain matriculating medical students’ experiences with death and dying, describe the range of students’ emotional responses, and identify reactions, behaviors, and perceived roles related to these and future experiences with death. Methods: We provided a writing prompt to newly matriculated medical students asking them to “reflect on experiences you may have had with family or friends near the end of life.” Content analysis was performed to identify themes in the responses. Results: The 104 students in the entering class submitted 90 individual free-text responses (87%). Most (57%) students specifically mentioned at least 1 personal experience with death, with a range of emotional responses including sadness (29%), surprise (14%), and guilt (12%). Distinct themes emerged on content analysis including personal experiences with death, anticipated response to death in future, changes in body or mind of the dying person, thoughts and observations about others, and cognitive or existential responses. Few students wrote about religion or spirituality (8%) or palliative or hospice care (2%). Conclusions: An understanding of students’ premedical school experiences and emotional reactions to death may help educators frame curricula around end-of-life care. Educators could apply enhanced awareness to help students process their own experiences as they begin caring for patients and to focus on areas that were underrepresented in students’ comments, such as religion, spirituality, palliative care, and hospice.

Patient's Death From the Perspective of Nursing Students

“…Every doctor, nurse, midwife, and physiotherapist will experience patient death in his work. Most people who choose a medical faculty will encounter such a situation during their studies, which is shown by the tests carried out by future doctors [(20), p. 123-133; (5), p. 110; (6), p. 108; (18), p. 207-228]. These results are consistent with our study, which showed that the vast majority of nursing students meet with the death of the patient very early, and almost all participants of master's studies experienced patient death at least once.…”

“…The education process is undoubtedly influenced by students' experience that results from their private lives. It is emphasized that knowing and understanding what future medical practitioners experience before starting education are crucial to correctly choose teaching methods to analyze their own experiences and their use in inpatient care [( 19 ), p. 999–1,007]. Proper preparation of mentors and their positive attitude toward students are the key to establishing an educational relationship.…”

“…The researcher did not want to limit himself to nursing students from one academic center to have more objective and varied data. The tool was created based on the analysis of the available literature and the authors' own thoughts [( 2 ), p. 803–805; ( 8 ), p. 1,442–1,457; ( 15 ), p. 266–272; ( 16 ), p. 279–291; ( 17 ), p. 448–453; ( 18 ), p. 207–228; ( 19 ), p. 999–1,007]. A pilot study was carried out to verify the quality of the resulting tool.…”

Coping with death in Paraguayan medical students in August 2021: a multicenter study

“…Las experiencias con la muerte suponen también un importante reto para ayudar a madurar y adaptarse a las tareas propias de la futura profesión, por su carácter motivador para el desarrollo de estrategias de afrontamiento (6) . En las carreras de ciencias de la salud se tiene contacto con la muerte desde el primer año por medio de las clases de disección en anatomía (7)(8)(9) . El proceso de morir y la muerte es un tema difícil de tratar hasta para los profesionales de la salud ya que genera estrés, ansiedad, malestar e incertidumbre.…”

A Multicenter Qualitative Analysis of Medical Student Narratives After a Palliative Care Elective

“…6,11 Previous studies evaluated medical student experiences around death and dying or PC through written reflections; however, most of these studies involved isolated clinical PC or hospice experiences and none have studied the narrative reflections of medical students across multiple U.S. medical schools after a dedicated clinical PC elective. [12][13][14][15][16] Our study aimed to understand medical student experiences of a clinical PC elective by analyzing reflective essays from 3 geographically diverse hospital systems in the United States.…”