The Impact of Guided Reflection in the Professional Development of Medical Students in the Context of Death and Dying.




Martin, Roy
Marquez-Hall, Sandra
Knebl, Janice
Hsu, Jennifer


Journal Title

Journal ISSN

Volume Title



Statement of the Hypothesis Medical students often struggle with end-of-life issues. To address this need, two educational sessions about death and dying were introduced to fourth year medical students during their Core Geriatric Clerkship. The curriculum included the use of guided reflection, which involves facilitated discussion and reflective writing, to help students identify and cope with their feelings about death and dying. Many students had reported struggling to identify their role as a health professional related to the topic of death and dying. This study explores the impact of helping students reflect on their understanding of a medical professionals role in death and dying. Brief Summary of Materials and Methods The idea for this project originated from the results of a previous study conducted by the Reynolds Geriatric Education and Training in Texas (GET-IT) program. A pre- and post-survey was administered to fourth year students (n-805) prior to the start and again at the end of the 4 week Core Geriatric Clerkship. The survey found that students felt less comfortable discussing palliative care and end-of-life issues after exposure during the rotation (pre-test mean: 4.20, post-test mean: 3.59, p A Summary of the most pertinent, significant results As part of their core geriatrics clerkship, fourth year medical students were required to attend two sessions on end-of-life care that included lecture, guided discussion, community resources and a reflective writing assignment. The follow-up self-assessment survey greatest improvement in competency was end-of-life care. In the pre-test students had reported 1.96 average mean in their comfort level related to End of Life Care; and, after participation in the revised curriculum, students reported an average mean score of 3.02. This findings indicate that the average student now feels they have “significant ability” to talk about end-of-life issues. Conclusions derived from the presented data Fourth year medical students at UNTHSC were found to have struggled with communication related to palliative care and end-of-life issues. By providing a safe platform for review and communication on end of life issues, the study found that students reported improved confidence in the ability to cope with death and dying. While 150 minutes of instruction cannot fully prepare students to cope with these difficult and sensitive issues, students can gain confidence in this area of their professional role as future physicians. Through peer support and faculty feedback, the guided reflection increased students’ belief in their own competence, freeing them to use their unique life experiences and skills to cope with death and dying.