Factors influencing the development of end-of-life communication skills: A focus group study of nursing and medical students. (January 2016)

• Record Type: Journal Article
• Authors: Gillett, Karen; O'Neill, Bernadette; Bloomfield, Jacqueline G.
• Is Part Of: Nurse education today. Volume 36(2016)
• Page Start: 395
• Page End: 400
• Publication Date: 2016-01
• Subjects: Focus groups -- Qualitative -- End-of-life -- Communication -- Dying -- Nursing students -- Medical students; Nursing -- Study and teaching -- Periodicals; Education, Nursing -- Periodicals; Soins infirmiers -- Étude et enseignement -- Périodiques; Nursing -- Study and teaching; Periodicals; 610.7307
• DOI: 10.1016/j.nedt.2015.10.015
• Languages: English
• ISSNs: 0260-6917

Abstract

Summary: Background: Poor communication between health care professionals and dying patients and their families results in complaints about end-of-life care. End-of-life communication skills should be a core part of nursing and medical education but research suggests that qualified doctors and nurses find this a challenging area of practice. Aims: The aim of this study was to explore factors influencing the development of end-of-life communication skills by nursing and medical students. Design: A qualitative study comprising five focus groups. Participants: Second year undergraduate nursing (n = 9 across 2 focus groups) and fourth year undergraduate medical students (n = 10 across 3 focus groups) from a London University. Findings: Barriers and facilitators influenced nursing and medical students' experience of communication with dying patients and their families in clinical practice. Extrinsic barriers included gatekeeping by qualified staff and lack of opportunity to make sense of experiences through discussion. Intrinsic barriers included not knowing what to say, dealing with emotional responses, wasting patients' time, and concerns about their own ability to cope with distressing experiences. Facilitating factors included good role models, previous experience, and classroom input. Conclusion: In addition to clinical placements, formal opportunities for reflective discussion are necessary to facilitate the development of students' confidence and skills in end-of-life communication. For students and mentors to view end-of-life communication as a legitimate part of their learning it needs to be specified written practice-learning outcome. Mentors and supervisors may require training to enable them to facilitate students to develop end-of-life communication skills. Highlights: Students have concerns about their own emotional responses to dying patients. Students' fear of saying the 'wrong' thing is a barrier to end-of-life communication. Gatekeeping by qualified staff limits students' interaction with dying patients. Facilitators for end-of-life communication include education and good role models. Facilitated discussion helps students make sense of end-of-life experiences.