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

¹ Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva
² Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva; Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, Geneva
³ Division of Geriatrics Division, Geneva University Hospitals, Geneva
⁴ Division of Liaison Psychiatry, Geneva University Hospitals, Geneva
⁵ Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, Geneva

^* To whom correspondence should be addressed.

	Abstract

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.

First published on November 7, 2008, doi:10.1177/0269216308098796

Palliative Medicine 2009;23:59.

A more recent version of this article appeared on January 1, 2009


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