Doctors' learning experiences in end-of-life care: a focus group study from nursing homes

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Standard

Doctors' learning experiences in end-of-life care : a focus group study from nursing homes. / Fosse, Anette; Ruths, Sabine; Malterud, Kirsti; Schaufel, Margrethe Aase.

I: B M C Medical Education, Bind 17, 27, 31.01.2017, s. 1-8.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Fosse, A, Ruths, S, Malterud, K & Schaufel, MA 2017, 'Doctors' learning experiences in end-of-life care: a focus group study from nursing homes', B M C Medical Education, bind 17, 27, s. 1-8. https://doi.org/10.1186/s12909-017-0865-8

APA

Fosse, A., Ruths, S., Malterud, K., & Schaufel, M. A. (2017). Doctors' learning experiences in end-of-life care: a focus group study from nursing homes. B M C Medical Education, 17, 1-8. [27]. https://doi.org/10.1186/s12909-017-0865-8

Vancouver

Fosse A, Ruths S, Malterud K, Schaufel MA. Doctors' learning experiences in end-of-life care: a focus group study from nursing homes. B M C Medical Education. 2017 jan 31;17:1-8. 27. https://doi.org/10.1186/s12909-017-0865-8

Author

Fosse, Anette ; Ruths, Sabine ; Malterud, Kirsti ; Schaufel, Margrethe Aase. / Doctors' learning experiences in end-of-life care : a focus group study from nursing homes. I: B M C Medical Education. 2017 ; Bind 17. s. 1-8.

Bibtex

@article{934fee13afc648dabfc24b56306aa576,
title = "Doctors' learning experiences in end-of-life care: a focus group study from nursing homes",
abstract = "Background: Doctors often find dialogues about death difficult. In Norway, 45% of deaths take place in nursing homes. Newly qualified medical doctors serve as house officers in nursing homes during internship. Little is known about how nursing homes can become useful sites for learning about end-of-life care. The aim of this study was to explore newly qualified doctors{\textquoteright} learning experiences with end-of-life care in nursing homes, especially focusing on dialogues about death.Methods: House officers in nursing homes (n = 16) participated in three focus group interviews. Interviews were audiotaped and transcribed verbatim. Data were analysed with systematic text condensation. Lave & Wenger{\textquoteright}s theory about situated learning was used to support interpretations, focusing on how the newly qualified doctors gained knowledge of end-of-life care through participation in the nursing home{\textquoteright}s community of practice.Results: Newly qualified doctors explained how nursing home staff{\textquoteright}s attitudes taught them how calmness and acceptance could be more appropriate than heroic action when death was imminent. Shifting focus from disease treatment to symptom relief was demanding, yet participants comprehended situations where death could even be welcomed. Through challenging dialogues dealing with family members{\textquoteright} hope and trust, they learnt how to adjust words and decisions according to family and patient{\textquoteright}s life story. Interdisciplinary role models helped them balance uncertainty and competence in the intermediate position of being in charge while also needing surveillance.Conclusions: There is a considerable potential for training doctors in EOL care in nursing homes, which can be developed and integrated in medical education. This practice based learning arena offers newly qualified doctors close interaction with patients, relatives and nurses, teaching them to perform difficult dialogues, individualize medical decisions and balance their professional role in an interdisciplinary setting.",
keywords = "Medical education, Qualitative research, Focus group, Doctor-/patient relationship, Internship and residency, Professional development, Nursing home, End of life care, Death",
author = "Anette Fosse and Sabine Ruths and Kirsti Malterud and Schaufel, {Margrethe Aase}",
year = "2017",
month = jan,
day = "31",
doi = "10.1186/s12909-017-0865-8",
language = "English",
volume = "17",
pages = "1--8",
journal = "B M C Medical Education",
issn = "1472-6920",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Doctors' learning experiences in end-of-life care

T2 - a focus group study from nursing homes

AU - Fosse, Anette

AU - Ruths, Sabine

AU - Malterud, Kirsti

AU - Schaufel, Margrethe Aase

PY - 2017/1/31

Y1 - 2017/1/31

N2 - Background: Doctors often find dialogues about death difficult. In Norway, 45% of deaths take place in nursing homes. Newly qualified medical doctors serve as house officers in nursing homes during internship. Little is known about how nursing homes can become useful sites for learning about end-of-life care. The aim of this study was to explore newly qualified doctors’ learning experiences with end-of-life care in nursing homes, especially focusing on dialogues about death.Methods: House officers in nursing homes (n = 16) participated in three focus group interviews. Interviews were audiotaped and transcribed verbatim. Data were analysed with systematic text condensation. Lave & Wenger’s theory about situated learning was used to support interpretations, focusing on how the newly qualified doctors gained knowledge of end-of-life care through participation in the nursing home’s community of practice.Results: Newly qualified doctors explained how nursing home staff’s attitudes taught them how calmness and acceptance could be more appropriate than heroic action when death was imminent. Shifting focus from disease treatment to symptom relief was demanding, yet participants comprehended situations where death could even be welcomed. Through challenging dialogues dealing with family members’ hope and trust, they learnt how to adjust words and decisions according to family and patient’s life story. Interdisciplinary role models helped them balance uncertainty and competence in the intermediate position of being in charge while also needing surveillance.Conclusions: There is a considerable potential for training doctors in EOL care in nursing homes, which can be developed and integrated in medical education. This practice based learning arena offers newly qualified doctors close interaction with patients, relatives and nurses, teaching them to perform difficult dialogues, individualize medical decisions and balance their professional role in an interdisciplinary setting.

AB - Background: Doctors often find dialogues about death difficult. In Norway, 45% of deaths take place in nursing homes. Newly qualified medical doctors serve as house officers in nursing homes during internship. Little is known about how nursing homes can become useful sites for learning about end-of-life care. The aim of this study was to explore newly qualified doctors’ learning experiences with end-of-life care in nursing homes, especially focusing on dialogues about death.Methods: House officers in nursing homes (n = 16) participated in three focus group interviews. Interviews were audiotaped and transcribed verbatim. Data were analysed with systematic text condensation. Lave & Wenger’s theory about situated learning was used to support interpretations, focusing on how the newly qualified doctors gained knowledge of end-of-life care through participation in the nursing home’s community of practice.Results: Newly qualified doctors explained how nursing home staff’s attitudes taught them how calmness and acceptance could be more appropriate than heroic action when death was imminent. Shifting focus from disease treatment to symptom relief was demanding, yet participants comprehended situations where death could even be welcomed. Through challenging dialogues dealing with family members’ hope and trust, they learnt how to adjust words and decisions according to family and patient’s life story. Interdisciplinary role models helped them balance uncertainty and competence in the intermediate position of being in charge while also needing surveillance.Conclusions: There is a considerable potential for training doctors in EOL care in nursing homes, which can be developed and integrated in medical education. This practice based learning arena offers newly qualified doctors close interaction with patients, relatives and nurses, teaching them to perform difficult dialogues, individualize medical decisions and balance their professional role in an interdisciplinary setting.

KW - Medical education

KW - Qualitative research

KW - Focus group

KW - Doctor-/patient relationship

KW - Internship and residency

KW - Professional development

KW - Nursing home

KW - End of life care

KW - Death

U2 - 10.1186/s12909-017-0865-8

DO - 10.1186/s12909-017-0865-8

M3 - Journal article

C2 - 28143600

VL - 17

SP - 1

EP - 8

JO - B M C Medical Education

JF - B M C Medical Education

SN - 1472-6920

M1 - 27

ER -

ID: 180572912