How do junior doctors in the UK learn to provide end of life care: a qualitative evaluation of postgraduate education

BMC Palliative Care

Research Article

Susie Schofield¹  Sophie Price² 

[1] Centre for Medical Education, University of Dundee, DD1 4NH, Dundee, Scotland, UK;MacMillan Unit, Christchurch Hospital, Fairmile Road, Christchurch, BH23 2JX, Dorset, UK;

关键词: Palliative Care;    Junior Doctor;    Life Care;    Palliative Medicine;    Palliative Care Team;   

DOI  :  10.1186/s12904-015-0039-6

 received in 2015-04-19, accepted in 2015-09-07,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe fundamental importance of good end of life care has been well documented however recent national publications have high-lighted inadequacies in training in this area. For many patients dying in the UK today care is provided in hospital and the number of inpatient deaths is forecast to climb significantly in future. The demands of providing medical care for these patients by junior doctors will continue to rise. However, there is currently only limited research on training for doctors in this setting.MethodsA qualitative study using semi-structured interviews of trainees working in general medicine analysed utilising a grounded theory approach.ResultsEleven medical trainees from nine different medical schools participated. They had worked in fifteen different UK hospitals in the course of their careers. All of the doctors interviewed felt generally confident in managing a dying patient. This had developed at postgraduate level and increased when working in certain key specialties. Emerging themes fell into five main categories: perceived ability in clinical management, different learning opportunities experienced, the impact of variations in approach to end of life care, the role of the specialist palliative care team and suggestions for improvements to training. All participants felt further teaching would be beneficial.ConclusionsThis study identified key areas where training could be improved. This included small changes in everyday practice to shift the emphasis for trainees to education. There also needs to be focus on end of life care in the curriculum, formal teaching programmes and assessment of junior doctors. The specialist palliative care team played a vital role in training as well as service provision. For those working in this specialty, every clinical encounter provides an opportunity for education. Specifically targeting junior doctors will not only improve patient care today but empower the consultants of the future.

【 授权许可】

CC BY   
© Price and Schofield. 2015