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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
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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

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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