A Multicenter Qualitative Analysis of Medical Student Narratives After a Palliative Care Elective

Abstract

Background: The medical student experience of a clinical elective in palliative care (PC) remains understudied. Reflective narrative interventions can help students hone narrative competency skills, make sense of their clinical experiences and shed light on their perception of the rotation. Objectives: To evaluate medical student written reflections after a PC clinical elective. Design: Students were asked to write a short reflective essay after PC clinical electives using open-ended writing prompts. Setting: Essays were collected from third and fourth-year medical students after completion of a PC elective at three geographically diverse academic medical centers in the United States. Measurements: Essays were coded for themes using a conventional content qualitative method of analysis. Results: Thirty-four essays were analyzed and four major themes emerged: reflection on the mission of medicine or motivation for being in medicine, reflection on professional skills or lessons learned, reflection on patient’s experience and personal responses to PC rotation. Sub-themes were also identified. Conclusions: Themes underscore the utility of the PC clinical elective as a meaningful experience that imparts useful skills, builds empathy, reminds students of their own motivations for being in medicine and serves as a catalyst for reflection on their own lives and relationships with their patients. Awareness of medical students’ personal and emotional responses to a PC elective can help inform educators as they support their students and provide opportunities for reflection and education.