‘They’ve got to learn’ — a qualitative study exploring the views of patients and staff regarding medical student teaching in a hospice

Abstract

UK medical school curricula incorporate training in end-of-life care as recommended by Tomorrow's Doctors. Previous research suggests that hospice staff have concerns about the burden on patients when participating in medical student teaching and may gatekeep access to patients. This qualitative study uses semistructured interviews to explore and compare the views of hospice patients and health care staff about patient involvement in medical student teaching. Fifteen patients and 14 staff members were recruited from a single UK hospice involved in teaching third year medical students. Hospice patients, who have been involved in teaching, are strongly positive about meeting medical students and staff carefully select patients based on a number of issues.

Are newly qualified doctors prepared to provide supportive and end-of-life care? A survey of Foundation Year 1 doctors and consultants

“…In another survey, Arolker et al interviewed palliative care professionals and patients and found that while staff acted as 'gatekeepers' by 'protecting' the most unwell patients from medical students, the patients themselves were overwhelmingly positive about seeing students. 13 This was the case even for those who had a very poor performance status.…”

Medical students writing on death, dying and palliative care: a qualitative analysis of reflective essays

“…From the current and previous studies, students often reported feeling anxious (including how to control emotions and be empathetic) before the hospice/palliative care placement; however, they learnt from their experience, often becoming empowered from it 17 18. This could be addressed before a hospice visit by guided discussion prior to seeing palliative care patient and peer (student–student) preparation from students who have been to the hospice17 18 (table 2).…”

“…It is apparent students learn from powerful patient stories and need to develop their reflective skills to build upon these descriptive accounts. Based on the review of essays and previous studies,17 18 key factors were identified which are important in the use of reflective essays for learning tools in palliative and end-of-life care (table 2). Skills training should include teaching on how to reflect and write reflective essays, especially as this is also needed for continued professional development.…”

“…Previously, this research team reported positive responses from hospice patients towards medical students, but hospice staff expressed concerns regarding patient and student welfare leading to gatekeeping 17. A subsequent study by this research team found that, although medical students feared hospice placements, this was alleviated during the placement and they felt supported, reporting an enjoyable and valuable learning opportunity with inspiring patient encounters 18.…”

Introducing Palliative Care into Entry-Level Physical Therapy Education

“…6 An understanding of a palliative approach to care is a core skill for clinicians and therefore content relating to palliative care would be expected to be included in all physical therapy entry-level programs. Challenging students' misconceptions about palliative care is viewed as an important part of medical undergraduate education 7 and should be seen as equally important for student physical therapists preparing for their role in the interdisciplinary management of people with lifelimiting illnesses. 8 Although the management of people undergoing palliative care should be considered an essential skill for practicing clinicians, the availability of physiotherapists with acknowledged expertise in this area is limited.…”