What It's Really Like: The Complex Role of Medical Students in End-of-Life Care

Abstract

Background: Medical student end-of-life care training provides insight into the hidden curriculum and physician professional development. Description: Second-year medical students at a university medical center listen to a panel discussion of 4th-year students and residents describing their end-of-life care experiences during clerkships. This discussion is intended to provide “anticipatory guidance” to 2nd-year students about challenging situations they might encounter on the wards. The purpose of this study was to analyze the content of the panel discussions by 4th-year students and residents to better understand their views of the end-of-life care curriculum. Evaluation: We performed a qualitative content analysis of transcripts from 2 years of panel discussions. Participants' comments focused primarily on the complexity of the role of medical students in end-of-life care. Three major themes emerged in the sessions: defining professional identity, conflicting expectations, and limited medical experience. Conclusions: The role of medical students in end-of-life care can be complex, confusing, and contradictory. Emotional support and elucidating the hidden curriculum may assist students with the process of physician enculturation and end-of-life care education.

This work was supported, in part, by the Soros Foundation Project on Death in America, the UCSF Academy of Medical Educators, and the Office of Education in the UCSF School of Medicine.

For their openness and wisdom, we thank the student and housestaff panelists and the panel moderator. For their creative approach to preparing students to practice excellent end-of-life care, we thank the Foundations of Patient Care staff and course directors in addition to Drs. William Shore and Jessica Muller (Drs. Calvin Chou, Huiju Carrie Chen, Lowell Tong, Preetha Basaviah, and Cynthia Irvine, course administrator).