Changes Due to Patient Deaths: Medical Students’ Expectations vs. Health Professionals’ Experiences

Abstract

ContextPreparing healthcare professionals for inevitable encounters with patient deaths is crucial to preventing maladaptive professional bereavement outcomes. ObjectivesThis study aimed to explore the discrepancies between medical students’ pre-patient death expectations and healthcare professionals’ post-patient death experiences regarding accumulated global changes due to patient deaths (AGC), identify heterogeneous expectation patterns among students, and reveal risk factors for worthy-of-concern expectation patterns. MethodsCross-sectional survey data from 231 professional caregivers and 405 medical and nursing students were used. Independent t tests and analyses of covariance were run for staff-student AGC comparisons. Latent profile analysis (LPA) among students was followed by logistic regression. ResultsThe students scored higher than did the staff in two AGC factors: more acceptance of limitations and more death-related anxiety. LPA identified four latent expectation patterns, with the “overoptimistic” (27.8%) group being worthy of concern, as students overestimated positive changes and underestimated negative changes. The overoptimistic pattern was predicted by students' motivations to study medicine, which were driven by “interests,” “career opportunities,” and “improving medical services in the hometown,” rather than “by chance,” and higher scores on the death attitude of "neutral acceptance." ConclusionIn general, students tend to overestimate the long-term impacts of patient deaths. However, approximately 1/4 of students hold overly optimistic expectations, which are predicted by motivations to study medicine and death attitudes.