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Difficulties of residents in training in end-of-life care. A qualitative study

Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva christophe.luthy{at}hcuge.ch

C Cedraschi

Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva; Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, Geneva

S Pautex

Division of Geriatrics Division, Geneva University Hospitals, Geneva

D Rentsch

Division of Liaison Psychiatry, Geneva University Hospitals, Geneva

V Piguet

Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, Geneva

AF Allaz

Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva

Residents in training are first-line physicians in hospital settings and they are in the process of developing knowledge and mastering clinical skills. They have to confront complex tasks calling upon their personal background, professional identity and relationships with the patients. We conducted a qualitative study investigating the difficulties they perceive in end-of-life care. In all, 24 consecutive residents were presented with a written query asking them to indicate the difficulties they identify in the management of patients hospitalised for end-of-life care. Their responses were submitted to content analysis. Physicians’ mean age was 28 ± 2.2 years, 37% were women, average postgraduate training duration was 2.5 ± 1.3 years. Content analysis elicited eight categories of difficulties: abitily to provide adequate explanations, understand the patients’ needs, have sufficient theoretical knowledge, avoid flight, avoid false reassurance, manage provision of time, face one’s limits as a physician and be able to help despite everything. Residents’ responses showed that they identify the complexity of care in terminally-ill patients early in their training. Their responses pointed to the ‘right distance’ in-between getting involved and preserving oneself as a dimension of major importance.

Key Words: communication • end-of-life care • patient-physician relations • residents’ difficulties.

This version was published on January 1, 2009

Palliative Medicine, Vol. 23, No. 1, 59-65 (2009)
DOI: 10.1177/0269216308098796


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