"This is just too awful; I just can't believe I experienced that...": medical students' reactions to their "most memorable" patient death

Acad Med. 2005 Jul;80(7):634-40. doi: 10.1097/00001888-200507000-00005.


Purpose: To examine medical students' emotional reactions to their "most memorable" patient death and the support they receive.

Method: In 2000-01, 65 third-year medical students at two Northeastern U.S. medical schools were randomly selected to participate in 60-90-minute interviews of open-ended and structured questions and a written questionnaire (using a ten-point scale) about their "most memorable" patient death. Independent reviewers coded each interview to identify the analytical categories. Descriptive data were generated from the written questionnaire.

Results: A total of 32 interviews were used in the analysis. Twelve (38%) students were in contact with the patient for less than 24 hours and 23 (73%) were not at all or minimally close to the patient (0-3 on ten-point scale). Sixteen of 28 students (57%) rated the impact of the death as highly emotionally powerful (7-10 on ten-point scale). The finality of deaths, particularly sudden deaths, evoked strong emotions. Four of 16 (25%) students who found the death highly emotionally powerful rated the amount of support from supervisors as extremely inadequate (0-3 on ten-point scale). There was no discussion of the death in 17 (63%) of the 27 cases in which the patient was cared for by the student's team. Students perceived from supervising physicians that death and emotions are negative aspects of medicine.

Conclusions: Medical students experienced patient deaths as emotionally powerful even when they were not close to the patients. Debriefing sessions with students were rare, and many students felt inadequately supported. Thus, a unique opportunity to teach about death, emotions and coping with stress is often lost.

MeSH terms

  • Adaptation, Psychological
  • Attitude of Health Personnel*
  • Attitude to Death*
  • Clinical Clerkship
  • Education, Medical, Undergraduate
  • Emotions
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • New England
  • Physician-Patient Relations*
  • Social Support
  • Students, Medical / psychology*
  • Surveys and Questionnaires
  • Terminal Care / psychology*