Resident physician interactions with surrogate decision-makers: the resident experience

Area of Science:

• Medical Education
• Patient-Physician Communication
• Bioethics

Background:

• Interactions between medical residents and patient surrogates are crucial for patient care.
• Understanding resident roles, emotional experiences, and learning processes in these interactions is vital.
• Existing formal education on surrogate decision-making appears limited.

Purpose of the Study:

• To explore medical residents' understanding of their roles and relationships with patient surrogates.
• To investigate the emotional experiences of residents during interactions with surrogates.
• To clarify the learning processes involved in resident-surrogate decision-making.

Main Methods:

• Qualitative analysis of in-depth interviews with 18 second- and third-year family medicine residents.
• Residents described memorable interactions with surrogates and discussed their learning.
• Verbatim interview transcripts were analyzed through an iterative process.

Main Results:

• Residents experienced significant emotional burden but valued relationships with surrogates.
• Residents adopted various roles, providing support, information, and advice despite reservations.
• Residents primarily relied on role modeling and prior experiences for guidance, with minimal formal education.

Conclusions:

• Medical residents engage in complex, emotionally significant interactions with surrogates.
• Formal education on surrogate decision-making and resident emotional processing is insufficient.
• Educational interventions should focus on resident emotions and ethical beliefs to improve surrogate support and value-based conversations.