Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-29T04:58:36.307Z Has data issue: false hasContentIssue false
  • English
  • Français

Preparation of residents for death pronouncement: A sensitive and supportive method

Published online by Cambridge University Press:  07 December 2005

F. AMOS BAILEY  and
BEVERLY ROSA WILLIAMS
F. AMOS BAILEY
Affiliation:
Birmingham VAMC, Assistant Professor of Geriatrics and Gerontology, University of Alabama, Birmingham, Birmingham, Alabama
BEVERLY ROSA WILLIAMS
Affiliation:
University of Alabama at Birmingham Center for Aging, Department of Medicine, Division of Gerontology and Geriatric Medicine, Birmingham, Alabama
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: To identify factors associated with internal medicine interns' self-assessed competency in death pronouncement and to evaluate the effectiveness of a 10-minute death pronouncement module and pocket card guidelines.

Methods: In June 2003 at the Birmingham VAMC, Alabama, 48 internal medicine interns completed a survey of medical school education, training, and experience in death pronouncement and a self-assessment of death pronouncement competency. In September 2003, 33 of the 48 interns completed a follow-up training/education survey and rated their post-intervention competency. Using chi-square and paired t-tests, we identified factors associated with variations among baseline and post-intervention variables and examined pre-post changes in self-assessed competency levels.

Results: At baseline, less than 30% of the interns had medical school instruction in the process of death pronouncement. More than 70% reported needing basic instruction/close supervision. Post-intervention, close to 90% interns needed minimal or no assistance. Over 50% reported using pocket card guidelines. We found significant pre-post increases in mean rankings in each of the 5 self-assessed competencies (p < .001). Factors associated with differences in baseline and post-intervention assessments included medical school training/experience and use of the pocket card guidelines.

Significance of results: When interns began training, most had no instruction in death pronouncement and felt unprepared for this task. With brief instruction, pocket card guidelines, and 3-months experience, the majority of interns reported needing minimal/no assistance in pronouncing death. A larger sample from multiple sites is needed to confirm these findings.

Keywords

Death pronouncementMedical resident education
Type
Research Article
Information
Palliative & Supportive Care , Volume 3 , Issue 2 , June 2005 , pp. 107 - 114
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bailey, F.A. (2003). The Palliative Response. Birmingham, AL: Menasha Ridge Press.
Ellison, N.M. & Ptacek, J.T. (2002). Physician interactions with families and caregivers after a patient's death: Current practices and proposed changes. Journal of Palliative Medicine, 5, 49–55.Google Scholar
Lerman, R. (2003). Death rituals. Annals of Internal Medicine, 139, 384.Google Scholar
Magrane, B.P., Gilliland, M.F.G., & King, D. (1997). Certification of death by family physicians. American Family Physician, 1433–1438.Google Scholar
Marchard, L. & Kushner, K. (2004). Using the teachable moment in end-of-life care residency training. Journal of Palliative Medicine, 7, 80–84.Google Scholar
Marchard, L.R., Kushner, K.P., & Siewert, L. (1998). Death pronouncement: Survival tips for residents. American Family Physician, 58, 284–285.Google Scholar
Marshall, S. & Jones, A.H. (1993). Pronouncing death. In On Call: Principles and Protocols. Philadelphia: Saunders.
Pollack, M. (1999). Educating new resident physicians in death notification. Adad Med, 74, 721.Google Scholar
Schmidt, T., Norton, R., & Tolle, S. (1992). Sudden death in the ED: Educating residents to compassionately inform families. Journal of Emergency Medicine, 10, 643–647.Google Scholar