Redesigning Death Rounds: Alleviating distress for residents in end-of-life care.

Area of Science:

• Medical Education
• Palliative Care
• Physician Well-being

Background:

• Limited end-of-life care training negatively impacts residents, leading to burnout and suboptimal patient care.
• An academic hospital implemented monthly Death Rounds (DR) for medical intensive care unit residents to address emotional challenges in caring for dying patients.

Purpose of the Study:

• To implement and evaluate a newly structured Death Rounds (DR) curriculum.
• To enhance residents' reflection on end-of-life care experiences.
• To reduce emotional burnout and improve physician well-being.

Main Methods:

• A mixed-methods design incorporating a qualitative needs assessment via resident interviews.
• Modifications to the DR conference based on needs assessment: shorter, frequent sessions, breakout groups, discussion prompts, and multidisciplinary facilitators.
• Pre- and post-modification surveys using Likert scales to assess programmatic changes.

Main Results:

• Post-modification data from 50 residents showed a greater proportion of attendees felt less distressed caring for dying patients (p=0.018).
• Non-attendees reported greater agreement on feeling emotionally supported by their team (p=0.046).
• 81% of post-test respondents found DR worthwhile, and most agreed discussing patient death's emotional impact is important.

Conclusions:

• Death Rounds (DR) is a replicable and impactful curriculum for processing end-of-life care challenges.
• The program may improve residents' emotional distress and enhance team support.
• Structured DR can contribute to improved physician well-being in critical care settings.