Care of the dying : a qualitative exploration of foundation year doctors’ experiences

Redman, Melody; Pearce, Jessica; Gajebasia, Sareena; Johnson, Miriam; Finn, Gabrielle

Abstract

Context
Foundation Year doctors (FYs), who are newly qualified, are expected to provide care for dying patients. Experiences at this early mandatory stage of training may form the foundation for future encounters, but little is documented about what these experiences involve. The aim of this research was to explore the experiences of FYs in caring for the dying, using the recently published ‘Priorities for Care of the Dying Person’1 as a conceptual framework, to identify areas for improvement in education and clinical practice.
Methods
Semi-structured group and individual interviews were conducted to explore the experiences of FYs and how these relate to the five aspects of Priorities for Care of the Dying Person: ‘recognise’, ‘communicate’, ‘involve’, ‘support’ and ‘plan and do’. All FYs in the North Yorkshire and East Coast Foundation School (n=335) were invited to participate and 47 FYs were recruited from five sites through convenience sampling and snowballing. Recordings were transcribed verbatim and a framework analysis approach was used with the published Priorities for Care of the Dying Person guidelines as a conceptual framework.
Results
Five main themes and 13 subthemes emerged from the data. The five main themes, which mapped to the conceptual framework, were: recognition that the patient is dying; communication with the patient, family and other staff; involvement of the patient and family in their care; support for the dying person and their family; and planning and carrying out good care of the dying. Examples of when things are done poorly or done well were shared, giving context to experience.
Conclusions
Areas for improvement were identified around all five main themes. These will be useful for informing those involved in undergraduate and foundation training on how to improve the experiences of Foundation Year doctors and thereby improve patient care.

Citation

Redman, M., Pearce, J., Gajebasia, S., Johnson, M., & Finn, G. (2017). Care of the dying : a qualitative exploration of foundation year doctors’ experiences. Medical Education, 51(10), 1025-1036. https://doi.org/10.1111/medu.13358

• Acceptance Date: Apr 20, 2017
• Online Publication Date: Jul 26, 2017
• Publication Date: 2017-10
• Deposit Date: May 8, 2017
• Publicly Available Date: Jul 27, 2018
• Journal: Medical education
• Print ISSN: 0308-0110
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 51
• Issue: 10
• Pages: 1025-1036
• DOI: https://doi.org/10.1111/medu.13358
• Keywords: Clinical education; Communication skills; Continuing medical education; Intern/house officer training; Qualitative research methods
• Public URL: https://hull-repository.worktribe.com/output/451143
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/medu.13358/full
• Additional Information: This is the accepted manuscript of an article published in Medical education, 2017. The version of record is available at the DOI link in this record.
• Contract Date: May 8, 2017