Residents learning from a narrative experience with dying patients: a qualitative study

Area of Science:

• Medical Education
• Palliative Care
• Narrative Medicine

Background:

• End-of-life care requires addressing patients' psychological, existential, and spiritual distress.
• Medical trainees often feel unprepared to provide comprehensive, humanistic care.
• Gaps exist in teaching the non-physical aspects of care and the value of narrative.

Purpose of the Study:

• To evaluate the dignity interview as an educational intervention for first-year residents.
• To address perceived gaps in non-physical end-of-life care.
• To stimulate reflection on narrative's role in humanistic medical education.

Main Methods:

• Twelve first-year residents conducted a 1-hour dignity interview with dying patients.
• Residents transcribed and read the life stories back to patients.
• Semi-structured interviews with residents were analyzed using the constant comparative method.

Main Results:

• Residents found the dignity interview distinct from traditional medical interviews.
• The experience prompted reflection on patient-derived lessons and personal/professional growth.
• Residents perceived that soliciting patient stories is undervalued and poorly taught in medical education.

Conclusions:

• The dignity interview is a valuable tool for enhancing residents' understanding of humanistic end-of-life care.
• Medical education needs to better integrate narrative and patient storytelling into the curriculum.
• Addressing the 'hidden curriculum' is crucial for fostering physicians who value the whole person.