Connect or detach: A transformative experience for medical students in end‐of‐life care.

Context: At the beginning of clinical practice, medical students face complex end‐of‐life (EoL) decisions, such as limiting life‐sustaining therapies, which may precipitate emotionally charged moral dilemmas. Previous research shows these dilemmas may cause identity dissonance and impact students' p...

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Publicado en:Medical Education Vol. 59; no. 4; pp. 395 - 409
Autores principales: Ribeiro, Diego Lima, Sacardo, Daniele, Drzazga, Grazyna, de Carvalho‐Filho, Marco Antonio
Formato: pictorial research Journal Article
Publicado: Wiley-Blackwell Apr2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2025
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/medu.15545
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        atl: Connect or detach: A transformative experience for medical students in end‐of‐life care.
      aug:
        au:
          Ribeiro, Diego Lima
          Sacardo, Daniele
          Drzazga, Grazyna
          de Carvalho‐Filho, Marco Antonio
        affil: Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
      sug:
        subj:
          Terminal Care
          Students, Medical
          Student Attitudes Evaluation
          Morals
          Decision Making, Ethical
          Treatment Withdrawal
          Human
          Male
          Female
          Young Adult
          Brazil
          Cross Sectional Studies
          Qualitative Studies
          Thematic Analysis
          Uncertainty
          Emotions
          Social Distancing
          Coping
          Professional Development
          Commitment
          Patient Centered Care
          Emotional Regulation
          Descriptive Statistics
          Male
          Female
      ab: Context: At the beginning of clinical practice, medical students face complex end‐of‐life (EoL) decisions, such as limiting life‐sustaining therapies, which may precipitate emotionally charged moral dilemmas. Previous research shows these dilemmas may cause identity dissonance and impact students' personal and professional development. Despite the prevalence of such dilemmas, medical educators have limited insight into how students navigate these often emotional experiences. This study explores how medical students make sense of and deal with moral dilemmas lived during EoL's care. Methods: This cross‐sectional qualitative study used thematic analysis (Braun and Clarke) to analyse interviews with 11 Brazilian final‐year medical students. The interviews followed the drawing of a rich picture representing moral dilemmas experienced by medical students when engaging with EoL care. The reporting of this study follows the Standards for Reporting Qualitative Research (SRQR). Results: Participants highlighted four main themes when engaging with EoL care: 'experiencing death', 'making decisions at the end‐of‐life', 'connecting versus detaching: an upsetting dilemma' and 'being transformed'. They described the emotional overwhelm of experiencing death and the uncertainty in navigating EoL decisions. The central moral dilemma faced was whether to connect with or detach from patients. This dilemma was lived in the context of a hidden curriculum that preaches emotional distancing as a coping mechanism. Developing the moral courage to overcome this barrier and choosing to connect became a transformative experience, significantly impacting their personal and professional development and reinforcing their commitment to patient‐centred care. Conclusion: Connecting with patients in EoL care involves breaking cultural norms to establish meaningful connections with patients aiming for compassionate care. This process may lead to identity dissonance and also represents an opportunity for transformative learning. Educators can support this transformative process by legitimating students' connections with patients, teaching emotional regulation strategies, and leveraging personal experiences to foster trust. Exploring emotional dilemmas associated with end‐of‐life decisions, @diegolimaribei4 reveal how final year medical students facing the pivotal moral challenge of connecting with or detaching from patients is a transformative journey.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        Journal Article
      ougenre: Article
    language: English
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