Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore.
Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610, Singapore.
BMC Med Educ. 2020 Dec 28;20(1):516. doi: 10.1186/s12909-020-02411-y.
BACKGROUND: The re-introduction of medical students into healthcare systems struggling with the COVID-19 pandemic raises concerns as to whether they will be supported when confronted with death and dying patients in resource-limited settings and with reduced support from senior clinicians. Better understanding of how medical students respond to death and dying will inform educationalists and clinicians on how to best support them. METHODS: We adopt Krishna's Systematic Evidence Based Approach to carry out a Systematic Scoping Review (SSR in SEBA) on the impact of death and dying on medical students. This structured search process and concurrent use of thematic and directed content analysis of data from six databases (Split Approach) enhances the transparency and reproducibility of this review. RESULTS: Seven thousand six hundred nineteen were identified, 149 articles reviewed and 52 articles included. The Split Approach revealed similar themes and categories that correspond to the Innate, Individual, Relational and Societal domains in the Ring Theory of Personhood. CONCLUSION: Facing death and dying amongst their patients affect how medical students envisage their personhood. This underlines the need for timely, holistic and longitudinal support systems to ensure that problems faced are addressed early. To do so, there must be effective training and a structured support mechanism.
背景:在医疗体系正努力应对 COVID-19 大流行的情况下,重新引入医学生,这引发了人们的担忧,即在资源有限的环境中面对死亡和临终患者时,他们是否会得到支持,以及资深临床医生的支持会减少。更好地了解医学生对死亡和临终的反应,将为教育工作者和临床医生提供如何最好地支持他们的信息。
方法:我们采用克里希纳的系统循证方法(SEBA 中的系统综述),对死亡和临终对医学生的影响进行系统综述。这种结构化的搜索过程和同时使用六个数据库的主题和定向内容分析(拆分方法)提高了本综述的透明度和可重复性。
结果:确定了 7619 篇文献,审查了 149 篇文章,纳入了 52 篇文章。拆分方法揭示了与人格的 Ring 理论中的先天、个体、关系和社会领域相对应的相似主题和类别。
结论:面对患者的死亡和临终,医学生对自己的人格有了不同的看法。这强调了需要及时、全面和纵向的支持系统,以确保尽早解决所面临的问题。要做到这一点,必须进行有效的培训和建立结构化的支持机制。
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