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Medical students' experiences of resuscitation and discussions surrounding resuscitation status
1Department of Medical Education, Northampton General Hospital, Northampton, UK.
Insights
Final-year medical students often find witnessing cardiopulmonary resuscitation (CPR) distressing and lack experience discussing resuscitation status with patients. Enhanced communication skills training is recommended for future doctors to improve these vital patient conversations.
Area of Science:
- Medical Education
- Cardiology
- Patient Communication
Background:
- In the UK, cardiopulmonary resuscitation (CPR) is standard unless a "Do Not Attempt CPR" order is in place.
- Physicians have a legal obligation to discuss CPR feasibility or futility with patients.
Purpose of the Study:
- To explore final-year medical students' experiences with resuscitation and discussions about resuscitation status.
- To assess students' preparedness for future informed discussions regarding resuscitation.
Main Methods:
- Twenty final-year medical students from two UK medical schools were interviewed.
- Verbatim interview transcripts underwent thematic analysis.
Main Results:
- Witnessing CPR was distressing for some students.
- A notable minority had not observed discussions about resuscitation status.
- Half of students reported being excluded from difficult conversations; only two felt comfortable initiating such discussions.
Conclusions:
- Doctors must be comfortable discussing resuscitation with patients.
- Communication skills training in medical school should incorporate resuscitation discussions due to their increasing importance.
Objectives:
In the UK, cardiopulmonary resuscitation (CPR) should be undertaken in the event of cardiac arrest unless a patient has a "Do Not Attempt CPR" document. Doctors have a legal duty to discuss CPR with patients or inform them that CPR would be futile. In this study, final-year medical students were interviewed about their experiences of resuscitation on the wards and of observing conversations about resuscitation status to explore whether they would be equipped to have an informed discussion about resuscitation in the future.
Methods:
Twenty final-year medical students from two medical schools were interviewed about their experiences on the wards. Interviews were transcribed verbatim, and thematic analysis was undertaken.
Results:
Students who had witnessed CPR on the wards found that aspects of it were distressing. A significant minority had never seen resuscitation status being discussed with a patient. No students reported seeing a difficult conversation. Half of the students interviewed reported being turned away from difficult conversations by clinicians. Only two of the twenty students would feel comfortable raising the issue of resuscitation with a patient.
Conclusion:
It is vital that doctors are comfortable talking to patients about resuscitation. Given the increasing importance of this aspect of communication, it should be considered for inclusion in the formal communication skills teaching during medical school.