Experiences of Female and Male Medical Students With Death, Dying, and Palliative Care: One Size Does Not Fit All.
BACKGROUND
Medical students learn about death, dying, and palliative care (DDPC) through formal curricular offerings and informal clinical experiences; however, the lessons learned in the clinic may be at odds with the formal curriculum. Reflective writing is a means for students to "bracket" their DDPC experiences and reconcile conflicts between the formal and informal curriculum.


OBJECTIVES
The aim of this study is to compare the level of reflection demonstrated in medical students' narratives on DDPC with other experiences and to examine the domains of professionalism that students perceive to be prevalent in their DDPC experiences.


METHODS
Third-year medical students submitted professionalism narratives during their internal medicine clerkship. We identified a subset of narratives related to DDPC (n = 388) and randomly selected control narratives (n = 153). We assessed the level of reflection demonstrated in the narratives using a validated rubric and analyzed the professionalism domains that students identified as relevant to their experience.


RESULTS
There was no difference in reflective level between DDPC and control narratives. Within the DDPC group, female students demonstrated higher reflection (2.24 ± 0.71) than male students (2.01 ± 0.77; P < .001). Caring, compassion and communication, and honor and integrity were prominent among DDPC narratives. More females identified caring, compassion, and communication as relevant to their DDPC experiences, whereas more males identified altruism.


CONCLUSION
Males and females have different perceptions of DDPC experiences, and female students appear to be more deeply impacted. These findings can help clinical faculty engage students more effectively with this challenging topic.
['Hoffman|Leslie A|LA|http://orcid.org/0000-0002-2251-0648', 'Mehta|Rakesh|R|', 'Vu|T Robert|TR|', 'Frankel|Richard M|RM|']
D000533:Altruism D001291:Attitude of Health Personnel D001293:Attitude to Death D002982:Clinical Clerkship D003142:Communication D003643:Death D004645:Empathy D005260:Female D007722:Health Knowledge, Attitudes, Practice D006801:Humans D007388:Internal Medicine D007857:Leadership D008297:Male D010166:Palliative Care D000068616:Professionalism D036301:Qualitative Research D012737:Sex Factors D013337:Students, Medical
death dying palliative care reflection professionalism end-of-life care medical education