The Forgotten Educational Needs of the House Staff: Training Internal Medicine Residents to Address End-of-Life Issues

2013 ◽  
Vol 67 (1-2) ◽  
pp. 147-153 ◽  
Author(s):  
Sara Moore Kerai ◽  
Margot Wheeler
Keyword(s):  
Internal Medicine ◽  
End Of Life ◽  
Death And Dying ◽  
Comfort Level ◽  
Listening Skills ◽  
Internal Medicine Residents ◽  
Life Issues ◽  
Teaching Point ◽  
On Line ◽  
End Of Life Issues

An intervention was conducted, aimed at providing residents in internal medicine with communication skills to address end-of-life issues with patients. Residents participated in two 1-hour educational sessions designed to teach a communication protocol, enhance listening skills, and to provide practice in effective communication in a safe, small-group format. An anonymous on-line survey assessed the effectiveness of the intervention. Twenty-five residents completed the intervention. There was a trend toward increased comfort level in addressing end-of-life issues among residents who completed the intervention, versus a comparison group. Residents who completed the intervention reported that using the words “death” and “dying” with patients and families was an important teaching point.

Death and Dying Content in Undergraduate Social Work Education: Student Views of Their Preparation for End-of-Life Practice

2004 ◽  
Vol 10 (1) ◽  
pp. 136-146 ◽  
Author(s):  
Sara Sanders
Keyword(s):  
Social Work ◽  
End Of Life ◽  
Social Work Education ◽  
Death And Dying ◽  
Work Practice ◽  
Social Work Practice ◽  
Education Student ◽  
Life Issues ◽  
End Of Life Issues ◽  
Work Education

The majority of the literature specific to end-of-life content within social work education has pertained to master's level students. This descriptive study examined how prepared 272 BSW students from Pennsylvania colleges and universities felt they were for addressing end-of-life issues in social work practice, regardless of setting. This study identified that students did not feel prepared to assist clients with end-of-life situations. Students provided a list of recommendations for the types of end-of-life content they thought should be included in the social work curriculum. Strategies for including end-of-life content into the baccalaureate social work curriculum are included.

Using Death Cafés as a method for discussing death and dying with third year student nurses

2021 ◽  
Vol 27 (7) ◽  
pp. 352-360
Author(s):  
Theresa Mitchell ◽  
Brian Nyatanga ◽  
Sue Lillyman ◽  
Mary Bruce ◽  
Sue Bryane
Keyword(s):  
Nursing Students ◽  
End Of Life ◽  
Death And Dying ◽  
Student Nurses ◽  
Structured Interviews ◽  
Face To Face ◽  
The Public ◽  
Sensitive Topics ◽  
Life Issues ◽  
End Of Life Issues

Background: Death Cafés are increasingly being held to facilitate discussions around death and dying and end-of-life issues with the public. They are thought to provide a safe, confidential and interactive space in which sensitive and supportive conversations about death and dying and end-of-life are shared. Aim: To explore nursing students' experiences of participating in a modified Death Café and its impact on their learning about death and dying. Methodology: A qualitative interpretive approach was employed using face-to-face semi-structured interviews with a purposive sample of third year student nurse volunteers. Thematic analysis was used to identify key themes. Findings: Students viewed the modified Death Cafés positively, reporting that they were stimulating, informative and worthwhile for discussing sensitive topics related to death and dying. Five themes were developed from interview data: anticipation of the Death Cafés; timing of the Death Cafés within the curriculum; facilitation; trust within the group and getting involved; and reflection on, and for, practice. Conclusion: Students voiced a preference to disclose their feelings about death to an expert facilitator in the more informal environment of a Death Café because they thought they might be judged by their nursing lecturers. Effective facilitation of a Death Café session is critical to encourage self-scrutiny and disclosure by students, and the modified Death Café sessions achieved this. Implications: It is expected that students may feel vulnerable while participating in a Death Café, but it is important that the sessions enable students to be open about their feelings about death and the reciprocal sharing of inner thoughts and feelings about death and dying.

scholarly journals Breaking the Silence Associated With Death and Dying: New Directions in End-of-Life Research

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 647-647
Author(s):  
Sara Stemen ◽  
Peter Lichtenberg
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Experiences ◽  
Death And Dying ◽  
Illustrative Case ◽  
Life Care ◽  
Comprehensive Overview ◽  
Life Issues ◽  
End Of Life Issues ◽  
Demographic Shifts

Abstract Conversations surrounding end-of-life care and bereavement continue to remain relatively silenced within gerontology and the general population. The purpose of this symposium is to break the silence associated with death, dying, and bereavement by sharing emerging perspectives and interventions related to end-of-life experiences. This symposium features four presentations that examine bereavement and end-of-life care from the viewpoints of individuals, families, practitioners, and researchers. Carr provides a comprehensive overview of the current state of research regarding death, dying, and bereavement - mapping out how current technological and demographic shifts have changed the nature of end-of-life experiences. Stemen presents an illustrative case study that examines how cause of death (e.g., chronic illness, suicide) shapes grief and subsequent social relationships for surviving individuals. Utz explores conversations that occur between families and professionals embedded within the hospice system, showcasing reactions from families who experienced live discharge from hospice services. Last, Ogle sheds light on the roles taken on by state tested nursing assistants (STNAs) in end-of-life care as well as the training and education they receive and need on end-of-life issues. Lichtenberg, our discussant, will tie these emerging perspectives together in order to initiate an important dialogue with attendees regarding the actions needed to break the silence associated with death and dying so that we can better serve individuals, families, and professionals.

End-of-Life Issues in Intensive Care Units

2020 ◽  
Author(s):  
Victoria Metaxa
Keyword(s):  
Palliative Care ◽  
Critical Care ◽  
End Of Life ◽  
Death And Dying ◽  
Disease Process ◽  
Life Issues ◽  
Advance Care Directives ◽  
Advance Care ◽  
End Of Life Issues ◽  
Potential Improvement

AbstractCritical care clinicians strive to reverse the disease process and are frequently faced with difficult end-of-life (EoL) situations, which include transitions from curative to palliative care, avoidance of disproportionate care, withholding or withdrawing therapy, responding to advance treatment directives, as well as requests for assistance in dying. This article presents a summary of the most common issues encountered by intensivists caring for patients around the end of their life. Topics explored are the practices around limitations of life-sustaining treatment, with specific mention to the thorny subject of assisted dying and euthanasia, as well as the difficulties encountered regarding the adoption of advance care directives in clinical practice and the importance of integrating palliative care in the everyday practice of critical-care physicians. The aim of this article is to enhance understanding around the complexity of EoL decisions, highlight the intricate cultural, religious, and social dimensions around death and dying, and identify areas of potential improvement for individual practice.

scholarly journals Strategies for Effective On-Call Supervision for Internal Medicine Residents: The Superb/Safety Model

2010 ◽  
Vol 2 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Jeanne M. Farnan ◽  
Julie K. Johnson ◽  
David O. Meltzer ◽  
Ilene Harris ◽  
Holly J. Humphrey ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Clinical Supervision ◽  
Critical Incident ◽  
General Medicine ◽  
Published Evidence ◽  
Internal Medicine Residents ◽  
Life Issues ◽  
Supervision Practices ◽  
End Of Life Issues ◽  
Attending Physicians

Abstract Background Supervision is central to resident education and patient safety, yet there is little published evidence to describe a framework for clinical supervision. The aim of this study was to describe supervision strategies for on-call internal medicine residents. Methods Between January and November 2006, internal medicine residents and attending physicians at a single hospital were interviewed within 1 week of their final call on the general medicine rotation. Appreciative inquiry and critical incident technique were used to elicit perspectives on ideal and suboptimal supervision practices. A representative portion of transcripts were analyzed using an inductive approach to develop a coding scheme that was then applied to the entire set of transcripts. All discrepancies were resolved via discussion until consensus was achieved. Results Forty-four of 50 (88%) attending physicians and 46 of 50 (92%) eligible residents completed an interview. Qualitative analysis revealed a bidirectional model of suggested supervisory strategies, the “SUPERB/SAFETY” model; an interrater reliability of 0.70 was achieved. Suggestions for attending physicians providing supervision included setting expectations, recognizing uncertainty, planning communication, having easy availability, reassuring residents, balancing supervision, and having autonomy. Suggested resident strategies for seeking supervision from attending physicians included seeking input early, contacting for active clinical decisions or feeling uncertain, end of life issues, transitions in care, or help with systems issues. Common themes suggested by trainees and attending physicians included easy availability and preservation of resident decision-making autonomy. Discussion Residents and attending physicians have explicit expectations for optimal supervision. The SUPERB/SAFETY model of supervision may be an effective resource to enhance the clinical supervision of residents.

scholarly journals Tailoring Traditional Interviewing Techniques for Qualitative Research with Seriously Ill Patients about the End-of-Life: A Primer

2010 ◽  
Vol 60 (1) ◽  
pp. 89-102 ◽  
Author(s):  
Dena Schulman-Green ◽  
Ruth McCorkle ◽  
Elizabeth H. Bradley
Keyword(s):  
End Of Life ◽  
Qualitative Interviews ◽  
Death And Dying ◽  
Life Issues ◽  
Research Findings ◽  
Research Questions ◽  
End Of Life Issues ◽  
Seriously Ill Patients ◽  
Interviewing Techniques ◽  
Seriously Ill

Conducting qualitative interviews with seriously ill individuals about end-of-life issues is challenging for interviewers seeking to understand the problems, processes, and experiences individuals undergo when faced with death and dying. Although all qualitative interviewers face issues of building trust and obtaining answers to their research questions, these issues are exacerbated for interviewers of end-of-life issues due to the challenges of debilitated participants, sensitive subject matter, and heightened emotionalism. The purpose of this article is to offer field-tested techniques to tailor basic interviewing practices for discussions of end-of-life issues with seriously ill individuals. Use of tailored techniques facilitates the comfort of both interviewer and participant and enhances the probability of obtaining complete and accurate data, which in turn can improve the effectiveness of subsequent programs, policies, and clinical practice based on research findings.

scholarly journals Interventions at the end of life – a taxonomy for ‘overlapping consensus’

2017 ◽  
Vol 2 ◽  
pp. 7 ◽  
Author(s):  
David Clark ◽  
Hamilton Inbadas ◽  
Ben Colburn ◽  
Catriona Forrest ◽  
Naomi Richards ◽  
...  
Keyword(s):  
End Of Life ◽  
John Rawls ◽  
Death And Dying ◽  
Legal Service ◽  
Shared Understanding ◽  
Overlapping Consensus ◽  
Health And Social Care ◽  
Life Issues ◽  
The Face ◽  
End Of Life Issues

Context:Around the world there is increasing interest in end of life issues. An unprecedented number of people dying in future decades will put new strains on families, communities, services and governments.  It will also have implications for representations of death and dying within society and for the overall orientation of health and social care. What interventions are emerging in the face of these challenges?Methods:We conceptualize a comprehensive taxonomy of interventions, defined as ‘organized responses to end of life issues’.Findings:We classify the range of end of life interventions into 10 substantive categories: policy, advocacy, educational, ethico-legal, service, clinical, research, cultural, intangible, self-determined. We distinguish between two empirical aspects of any end of life intervention: the ‘locus’ refers to the space or spaces in which it is situated; the ‘focus’ captures its distinct character and purpose. We also contend that end of life interventions can be seen conceptually in two ways – as ‘frames’ (organized responses that primarilyconstructa shared understanding of an end of life issue) or as ‘instruments’ (organized responses thatassumea shared understanding and then move to act in that context).Conclusions:Our taxonomy opens up the debate about end of life interventions in new ways to provide protagonists, activists, policy makers, clinicians, researchers and educators with a comprehensive framework in which to place their endeavours and more effectively to assess their efficacy. Following the inspiration of political philosopher John Rawls, we seek to foster an ‘overlapping consensus’ on how interventions at the end of life can be construed, understood and assessed.

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