The Three Breath Method: Teaching Coping Mechanisms for Processing Patient Death

Area of Science:

• Medical Education
• Emergency Medicine
• Psychology

Background:

• Emergency medicine (EM) physicians frequently encounter patient death, necessitating effective coping strategies.
• Mindfulness practices, such as focused breathing, can enhance emotional regulation and reduce stress in acute care settings.
• The "Three-Breath Guided Meditation" is a structured deep-breathing exercise utilized by physicians to manage stress.

Purpose of the Study:

• To assess emergency medicine physicians' perceived ability to process patient death.
• To explore coping strategies employed by EM physicians.
• To evaluate the effectiveness of "The Pause" and the "Three-Breath Method" in managing stress and processing patient death.

Main Methods:

• A 4-minute instructional video on the Three-Breath Technique was asynchronously delivered to EM residents and faculty.
• Participants completed a mixed-methods questionnaire assessing baseline experiences, coping practices, and comfort levels.
• Data were analyzed using descriptive statistics, Spearman's correlation, and thematic analysis.

Main Results:

• Of 49 respondents, 62% were EM physicians (39% attendings, 61% residents).
• Attending physicians reported greater comfort in processing patient death (mean=4.45) than residents (mean=3.75).
• Overall, 59% used "The Pause" or "The Three-Breath Method," with 94% reporting comfort in coping after patient death.

Conclusions:

• Physician comfort in processing patient death correlates with training level, with attendings feeling more prepared than residents.
• The Three-Breath Method is widely adopted and may enhance physicians' ability to process patient death, promoting emotional reconciliation and stress reduction.
• Further research should expand to additional specialties and emphasize individualized strategies for emotional well-being in clinical practice.