The impact of death and dying on the personhood of medical students: a systematic scoping review

Chong Yao Ho,Yong Hao Melvin Lai,Xin Ling Lisa Ngiam,Chin Howe Joshua Chia,Tze Yin Joshua Kuek,Jia Ying Low,Nur Haidah Ahmad Kamal,Ahmad Bin Hanifah Marican Abdurrahman,Ashley Ern Hui How,Sarah Kei Lauw ,Yun Ting Ong,Cheryl Shumin Kow,Ying Pin Toh,Lorraine Hui En Tan,Stephen Mason,Noreen Chan ,Annelissa Chin ,Jeng Long Chia,Min Chiam,Lalit Kumar Radha Krishna

doi:10.1186/s12909-020-02411-y

Abstract

BackgroundThe re-introduction of medical students into healthcare systems struggling with the COVID-19 pandemic raises concerns as to whether they will be supported when confronted with death and dying patients in resource-limited settings and with reduced support from senior clinicians. Better understanding of how medical students respond to death and dying will inform educationalists and clinicians on how to best support them.MethodsWe adopt Krishna’s Systematic Evidence Based Approach to carry out a Systematic Scoping Review (SSR in SEBA) on the impact of death and dying on medical students. This structured search process and concurrent use of thematic and directed content analysis of data from six databases (Split Approach) enhances the transparency and reproducibility of this review.ResultsSeven thousand six hundred nineteen were identified, 149 articles reviewed and 52 articles included. The Split Approach revealed similar themes and categories that correspond to the Innate, Individual, Relational and Societal domains in the Ring Theory of Personhood.ConclusionFacing death and dying amongst their patients affect how medical students envisage their personhood. This underlines the need for timely, holistic and longitudinal support systems to ensure that problems faced are addressed early. To do so, there must be effective training and a structured support mechanism.

Highlights

The re-introduction of medical students into healthcare systems struggling with the COVID-19 pandemic raises concerns as to whether they will be supported when confronted with death and dying patients in resource-limited settings and with reduced support from senior clinicians
Diversity of views and the presence of complex individual, academic, research, socio-cultural, professional and personal factors involved in understanding the impact of care of dying patients upon medical students served as the rationale for adopting Systematic Evidence Based Approach (SEBA) as its constructivist and relativist lens allows for the mapping of complex concepts from multiple angles [40,41,42,43]
Themes and categories identified Scrutiny of the findings by the expert and research teams found that themes and categories from the thematic and content analysis were consistent with one another

Summary

Introduction

The re-introduction of medical students into healthcare systems struggling with the COVID-19 pandemic raises concerns as to whether they will be supported when confronted with death and dying patients in resource-limited settings and with reduced support from senior clinicians. With nearly 20 million reported cases worldwide and at least 730,000 deaths [1,2,3,4], the COVID-19 global pandemic has stressed healthcare systems and impacted medical education curricula in numerous countries [5]. It is against this backdrop that medical students in certain countries are being asked to step into clinical wards and bolster primary medical teams, in some cases with minimal supervision [6,7,8,9,10]. Better understanding of how medical students respond to death and dying will inform educationalists and clinicians on how to better support them during this pandemic and beyond

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Discussion

Conclusion