Abstract
BackgroundThe fundamental importance of good end of life care has been well documented however recent national publications have high-lighted inadequacies in training in this area. For many patients dying in the UK today care is provided in hospital and the number of inpatient deaths is forecast to climb significantly in future. The demands of providing medical care for these patients by junior doctors will continue to rise. However, there is currently only limited research on training for doctors in this setting.MethodsA qualitative study using semi-structured interviews of trainees working in general medicine analysed utilising a grounded theory approach.ResultsEleven medical trainees from nine different medical schools participated. They had worked in fifteen different UK hospitals in the course of their careers. All of the doctors interviewed felt generally confident in managing a dying patient. This had developed at postgraduate level and increased when working in certain key specialties. Emerging themes fell into five main categories: perceived ability in clinical management, different learning opportunities experienced, the impact of variations in approach to end of life care, the role of the specialist palliative care team and suggestions for improvements to training. All participants felt further teaching would be beneficial.ConclusionsThis study identified key areas where training could be improved. This included small changes in everyday practice to shift the emphasis for trainees to education. There also needs to be focus on end of life care in the curriculum, formal teaching programmes and assessment of junior doctors. The specialist palliative care team played a vital role in training as well as service provision. For those working in this specialty, every clinical encounter provides an opportunity for education. Specifically targeting junior doctors will not only improve patient care today but empower the consultants of the future.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-015-0039-6) contains supplementary material, which is available to authorized users.
Highlights
The fundamental importance of good end of life care has been well documented recent national publications have high-lighted inadequacies in training in this area
Almost 50 % of deaths in the United Kingdom (UK) occur in hospital and most will be in a generalist setting [1]
Sample selection A sample of Core Medical Trainees (CMT) was chosen as they are the junior doctors most likely to be caring for dying patients on a regular basis [8]
Summary
The fundamental importance of good end of life care has been well documented recent national publications have high-lighted inadequacies in training in this area. The demands of providing medical care for these patients by junior doctors will continue to rise. There is currently only limited research on training for doctors in this setting. There has been increasing attention in recent years on the undergraduate curriculum in palliative medicine in the UK [4,5,6,7]. Despite this there is considerable evidence that newly qualified doctors feel unprepared to care for dying patients [8,9,10]. Research into training for junior doctors in hospital posts in this area remains limited
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