When Patients Die: Patient Memorials and Group Reflection in an Internal Medicine Residency Program

Authors

Nicole Oakman
Jonathan Lim
Christine Bui
Holland Kaplan
Stephanie Sherman

Publication Date

9-28-2020

Journal

Baylor University Medical Center Proceedings

DOI

10.1080/08998280.2020.1818164

PMID

33456146

PMCID

PMC7785196

PubMedCentral® Posted Date

9-28-2020

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Group reflection, patient death, patient memorial, physician grief

Abstract

Patient death is a formative and emotional experience for physicians. Medical trainees are particularly susceptible to the emotional impact of patient death. However, few studies have examined how trainees process patient death. This study describes annual patient memorials organized at a large multisite academic graduate medical education program. Peer-led, 1-hour patient memorial services were organized for internal medicine residents, including large and small group reflection, a moment of silence, and collective art projects. At the conclusion of each memorial, participants completed a 10-question survey regarding their experience during the memorial and their prior experiences with patient death. Ninety-nine surveys were analyzed over 2 years. Of resident respondents, 84% reported feeling comfortable or very comfortable participating in the memorials, and 93% rated reflection on patient death as important or very important. When asked how they reflect on patient death, 67% of residents reported processing patient death independently, while only 23% reported processing patient death with their medical teams. Patient memorials with small and large group discussions are easily adopted and replicated. Residents reflect on patient death frequently but often independently rather than with their medical teams. Patient memorials provide a venue for collective mourning and group reflection to support trainees.

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