ERIC Number: EJ1036053
Record Type: Journal
Publication Date: 2013-Oct
Abstractor: As Provided
Reference Count: 46
Residents Learning from a Narrative Experience with Dying Patients: A Qualitative Study
Tait, Glendon R.; Hodges, Brian D.
Advances in Health Sciences Education, v18 n4 p727-743 Oct 2013
For patients at the end of life, it is crucial to address the psychological, existential, and spiritual distress of patients. Medical education research suggests trainees feel unprepared to provide the whole person, humanistic care held as the ideal. This study used an empirically based narrative intervention, the dignity interview, as an educational intervention with first year residents. The interview helps patients tell and make meaning of their life story. The intervention was aimed at addressing trainee perceived gaps in the non-physical aspects of end-of-life care. It was also intended to stimulate broader reflection on lessons learned in medical education about the value of narrative as part of humanistic care. Twelve first year residents administered a 1 h interview to dying patients. The resident returned to read the transcribed story back to the patient. Semi-structured interviews of the residents were transcribed and analyzed using the constant comparative method to identify emergent themes. This experience was seen as distinct from the "traditional" medical interview. Residents reflected on lessons learned from patients and on their own professional and personal lives. Residents felt conversations with dying patients, and more broadly the art of soliciting a patient's story are poorly taught and modeled. More concerning, the hidden curriculum seems to be sending messages that learning a patient's story is not the domain of a physician and that it is not valued like the curing and technical imperatives. These findings have implications for medical education's ongoing attempts to better produce humanistic physicians.
Descriptors: Death, Medical Students, Holistic Approach, Interviews, Intervention, Story Telling, Personal Narratives, Reflection, Humanism, Semi Structured Interviews, Patients, Graduate Medical Education, Graduate Students, Physicians, Qualitative Research
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Publication Type: Journal Articles; Reports - Research
Education Level: Higher Education; Postsecondary Education
Authoring Institution: N/A