Cripe Larry D, Hedrick David G, Rand Kevin L, Burns Debra, Banno Daniella, Cottingham Ann, Litzelman Debra, Hoffmann Mary L, Martenyi Nora, Frankel Richard M
1 Department of Medicine, IU School of Medicine, Indianapolis, IN, USA.
2 IU Simon Cancer Center, Indianapolis, IN, USA.
Am J Hosp Palliat Care. 2017 Feb;34(1):79-84. doi: 10.1177/1049909115609296. Epub 2016 Jul 11.
More physicians need to acquire the skills of primary palliative care. Medical students' clerkship experiences with death, dying, and palliative care (DDPC), however, may create barriers to learning such skills during residency. Whether professional development is differentially affected by DDPC is unknown. This knowledge gap potentially hinders the development of educational strategies to optimize students' preparedness for primary palliative care.
Third-year students submitted professionalism narratives (N = 4062) during their internal medicine clerkship between 2004 and 2011. We identified DDPC-related narratives and then randomly selected control narratives. Narratives were compared by valence (positive or negative) and professionalism-related themes.
Less than 10% of the narratives were related to DDPC, but the majority was positive. There was a significant overlap in professionalism themes between DDPC and control narratives. The results suggest student preparedness for primary palliative care may be improved by addressing the common professionalism challenges of clinical clerkships.
更多医生需要掌握初级姑息治疗技能。然而，医学生在实习期间接触死亡、临终关怀和姑息治疗（DDPC）的经历，可能会在住院医师阶段为学习这些技能设置障碍。专业发展是否会因DDPC而受到不同影响尚不清楚。这一知识空白可能会阻碍优化学生对初级姑息治疗准备情况的教育策略的制定。
2004年至2011年期间，三年级学生在内科实习期间提交了职业素养叙述（N = 4062）。我们识别出与DDPC相关的叙述，然后随机选择对照叙述。通过情感倾向（积极或消极）和与职业素养相关的主题对叙述进行比较。
不到10%的叙述与DDPC相关，但大多数是积极的。DDPC叙述和对照叙述在职业素养主题上有显著重叠。结果表明，通过应对临床实习中常见的职业素养挑战，可能会提高学生对初级姑息治疗的准备情况。
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