Journal article
Palliative and end of life care and junior doctors’ a systematic review and narrative synthesis
- Abstract:
- Background Palliative and end-of-life care is a core competency for doctors and is increasingly recognised as a key clinical skill for junior doctors. There is a growing international movement to embed palliative care education in medical student and junior doctor education. To date there has been no review of the literature concerning the views and experiences of junior doctors delivering this care. Aim To review the published literature between 2000 and 2019 concerning junior doctors’ experience of palliative and end-of-life care. Methods Systematic literature review and narrative synthesis. Results A search of six databases identified 7191 titles; 34 papers met the inclusion criteria, with a further 5 identified from reference searching. Data were extracted into a review-specific extraction sheet and a narrative synthesis undertaken. Three key themes were identified: (1) ‘Significance of death and dying’: all papers found that junior doctors care for many patients approaching the end of life, and this often causes emotional distress and can leave persisting memories for many years afterwards; (2) ‘Thrown in at the deep end’: junior doctors feel unprepared and unsupported in providing palliative and end-of-life care; and (3) ‘Addressing the gaps’: junior doctors often experience a medical culture of disengagement towards dying patients and varying attitudes of senior doctors. Subsequently they have to learn the skills needed through seeking their own opportunities. Conclusion Medical education needs to change in order to better prepare and support junior doctors for their role in caring for dying patients. This education needs to focus on their knowledge, skills and attitudes.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 790.4KB, Terms of use)
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- Publisher copy:
- 10.1136/bmjspcare-2019-001954
Authors
- Publisher:
- BMJ Publishing Group
- Journal:
- BMJ Supportive and Palliative Care More from this journal
- Volume:
- 12
- Issue:
- e6
- Pages:
- e862-e868
- Publication date:
- 2019-11-13
- Acceptance date:
- 2019-10-28
- DOI:
- EISSN:
-
2045-4368
- ISSN:
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2045-435X
- Keywords:
- Pubs id:
-
pubs:1070579
- UUID:
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uuid:fad24fb8-81b4-424d-9891-2e7fa2de9c31
- Local pid:
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pubs:1070579
- Source identifiers:
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1070579
- Deposit date:
-
2019-11-08
Terms of use
- Copyright holder:
- Bharmal et al.
- Copyright date:
- 2019
- Rights statement:
- © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.
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