Patient Death Debriefing Sessions to Support Residents' Emotional Reactions to Patient Deaths

Abstract

ABSTRACT Background There is no standard way to help residents deal with the emotional impact of patient deaths. Most available curricula are time and resource intensive. Objective We introduced “Patient Death Debriefing Sessions” into an inpatient medical oncology rotation at Memorial Sloan Kettering Cancer Center to provide a structured yet practical way to address residents' emotional reactions following the death of a patient. A questionnaire was used to evaluate the impact of these sessions. Methods Patient Death Debriefing Sessions consist of a brief (~10 minutes), real-time (within 24–48 hours), consistent (following each death), attending physician–led debriefing that focuses on internal medicine residents' emotional reactions following patient deaths. Sessions were guided by a pocketcard tool and did not require faculty training. Residents completing a 4-week medical oncology rotation were surveyed before and after their rotation. Prerotation and postrotation mean differences were evaluated based on the number of sessions they participated in (0 to ≥ 3) using analyses of variance. Results Ninety-one of 92 participants spanning all training levels completed questionnaires (99% response rate). Of these, 79 (87%) encountered a patient death and were included in the analyses. Overall, residents found debriefing sessions helpful, educational, and appreciated attending physician leadership. The number of debriefing sessions positively influenced residents' perception of received support. Conclusions This high-yield, novel pilot curriculum supported residents' emotional reactions to patient deaths and may foster communication with team members, including supervising attending physicians. This program is easily implemented and could be adapted for use in other clinical settings.