Qualitative Study of Preclinical Medical Student Reflections on Required Palliative Care Experience.

Abstract

Medical schools are increasingly incorporating palliative care (PC) experiences to promote knowledge about patient-centered care and improve primary PC skills of future physicians; however, best practices for doing so remain underdeveloped. As part of a longitudinal four-year medical school curriculum, all preclinical second-year medical students spend one half-day embedded in a PC team in an academic hospital or in a home setting. To evaluate written reflections of preclinical medical students for themes and experience impact following a PC experience with an interdisciplinary clinical team. Qualitative analysis was used to evaluate students' reflections written within 1 week of completing the palliative medicine experience. Conventional content analysis was used using NVivo statistical software. Authors inductively developed a codebook based on a small sample of reflections which was subsequently used for coding all reflections. 138 reflections were completed and included in this analysis. Five primary themes were identified: (1) introduction to the content and substance of PC as a field; (2) understanding PC as a collaborative effort that relies on an interdisciplinary team; (3) observation leading to deeper understanding of communication techniques; (4) understanding of systems-level considerations and barriers to care; and (5) early PC shadowing influences early professional identify consideration. Students developed deeper understanding of PC, including communication skills and interdisciplinary collaboration, as well as insights about future professional identity formation. Findings highlight the value of incorporating a required PC experience for all preclinical medical students. Themes identify opportunities to support students in their professional growth.