1500P - Caring for carers: The impact of death & dying on doctors-in-training in an Irish tertiary referral hospital

Background

Approximately 50% of deaths worldwide occur in an acute hospital setting. Doctors-in-training (DITs) experience death & dying in many forms and settings, and at every stage of their medical training. They often feel unprepared or unsupported when providing this care, which can cause significant distress. Yet, our experience is that DITs do not receive much, if any, specific training or support in approaching these events. The purpose of this study is to establish the training and education received by DITs in Cork University Hospital in dealing with death and explore the concept of spirituality in relation to their own experiences.

Methods

We performed a qualitative survey of DITs using a 27-question electronic survey. Participants answered questions regarding the prior training or education they had received relating to death and dying, their confidence in recognising and managing dying, and their opinion on the adequacy of the training or support available currently. A modified version of the Spiritual Wellbeing Scale (SWBS) questionnaire, a validated tool to provide an overall measure of perceived spiritual quality of life, was used to assess impact on spirituality.

Results

130 DITs responded to our survey (female=75). 67% disagreed or strongly disagreed (n=87) that they have received adequate training in relation to death & dying. Almost half did not feel confident discussing end-of-life care with patients or their families (n=63), and 69% (n=88) felt that support offered after the death of a patient was inadequate. The vast majority agreed or strongly agreed (n=124) that end-of-life care was important to the delivery of acute care. 71% (n=92) reported that the death of a patient had had a personal impact on them. The median Existential Wellbeing Score was 44 (range 24-59), indicating a moderate sense of life satisfaction. Of note, however, 49% (n=64) responded that they felt unsettled about their future.

Conclusions

Patient deaths frequently impact DITs. This survey highlights the importance of improving the training and supports available to DITs in dealing with death & dying. This has the potential to benefit both DITs, through better wellbeing, and their patients, by improving confidence and competence providing end-of-life care.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Cork University Hospital Medical Oncology Department.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.