Rey Alicia, Cantin Boris, Bonvin Raphaël
Fribourg Hospital (HFR), Palliative Care Center, Villars-sur-Glâne, Switzerland.
University of Fribourg, Faculty of Biology and Medicine, Medical Education Unit, Fribourg, Switzerland.
GMS J Med Educ. 2025 Feb 17;42(1):Doc4. doi: 10.3205/zma001728. eCollection 2025.
All medical students are confronted with death during their medical curriculum. Despite this, too few qualitative studies have examined this reality's impact, the support provided by clinical supervisors and the theoretical instruction dedicated to this theme in the university curriculum. This study explores these issues and gives students an opportunity to express themselves, to improve their training and well-being during their pre-graduate.
DESIGN/METHOD: Qualitative study conducted via semi-structured interviews with 4 year medical students at the University of Fribourg engaged in clinical rotations in all the main medical specialties, with in-depth exploration of their experience with death, the support provided by their supervisors and the preparation provided by the university curriculum. A thematic analysis was conducted.
Five themes emerged: fantasies about death before the encounter, first encounters with death, need for a global approach, impact of clinical supervisors' skills and denial of death during training. Whether positive or negative, confronting death is often an intense experience for students. They value clinical supervisors who care about how they're feeling, which is all too rare. According to students, the curriculum absolutely needs to be improved to better prepare them for the reality on the ground.
This study highlights the intensity of students' experiences with death and enables us to propose necessary improvements to their support and training. We believe that students would benefit from a space in which to explore their experiences with death. This would enable them to develop better skills for supporting end-of-life patients and their loved ones, while enhancing their own resources.
所有医学生在其医学课程学习期间都会面对死亡。尽管如此,极少有定性研究探讨过这一现实情况的影响、临床督导提供的支持以及大学课程中针对该主题的理论教学。本研究探讨了这些问题,并为学生提供了一个表达自己的机会,以改善他们在研究生前阶段的培训和幸福感。
设计/方法:通过对弗里堡大学的四年级医学生进行半结构化访谈开展定性研究,这些学生参与了所有主要医学专业的临床轮转,深入探讨了他们与死亡的经历、督导提供的支持以及大学课程所做的准备。进行了主题分析。
出现了五个主题:遭遇死亡前对死亡的幻想、首次遭遇死亡、需要整体方法、临床督导技能的影响以及培训期间对死亡的否认。无论积极与否,面对死亡对学生来说往往是一次强烈的经历。他们重视关心他们感受的临床督导,而这种督导极为罕见。学生们认为,课程绝对需要改进,以便让他们更好地为实际情况做好准备。
本研究突出了学生与死亡经历的强度,并使我们能够对他们的支持和培训提出必要的改进建议。我们认为,学生将受益于一个探索他们与死亡经历的空间。这将使他们能够培养更好的技能来支持临终患者及其亲人,同时增强他们自身的能力。