Attitude to death and opinion of medical students on the top training

Abstract: Introduction: Currently, most people are inserted in a sociohistorical context of denial of death, including physicians who deal with dying daily who consider themselves unprepared in the face of the death of a patient. The discomfort of these professionals in the face of the death process is due in part to the lack of the training that occurred during graduation. Objective: This study aimed to analyze the opinion of medical students at the Faculdade Pernambucana de Saúde (FPS) about teaching and perceptions on death and dying during graduation, verify the importance in medical education and describe this approach through the students’ perspective. It is also objective to find aspects that influence the belief of undergraduates about the theme. Method: This is an exploratory cross-sectional study with quantitative method, conducted between August 2020 and July 2021. Data collection was carried out through online questionnaires, with a sample of 365 subjects, after acceptance and marking on the free and informed consent form, sent to students by e-mail. For analysis, epi-info software was used using relative and absolute frequencies to describe qualitative variables and position and dispersion measures to describe quantitative variables. The chi-square test was used to verify the chi-square test, considering a significance level of 5%. The study followed all the precepts of Resolution nº 510/2016 of the National Council of Ethics in Research and received approval from the ethics committee of the college under opinion number 4,228,016. Result: Most students associate anguish, fear, and sadness with the process of death and agree that the discussion of this process in graduation impacts on the practice of medicine and on the psychosocial well-being of the physician. The students agree that the approach to the death process happened in rare moments during graduation and consider it necessary to include more disciplines that address it. Conclusion: The discussion about the process of death and dying process during medical graduation is necessary, and the insertion of modules that approach it is recommended in the medical course of FPS to contribute to the students’ understanding of this process and in the psychological preparation of these students to deal with death in the exercise of the profession.

摘要：
引言：当前，绝大多数人身处否认死亡的社会历史语境之中，即便是每日直面死亡诊疗工作的医师，也坦言在面对患者死亡时毫无准备。这类专业人员在面对死亡过程时产生的不适情绪，部分源于其毕业阶段培训的缺失。
研究目的：本研究旨在分析伯南布哥健康学院（Faculdade Pernambucana de Saúde，简称FPS）医学生对毕业阶段死亡与临终相关教学及认知的看法，验证该主题在医学教育中的重要性，并从学生视角阐述该主题的教学开展情况；同时探寻影响本科生对该主题认知的相关因素。
研究方法：本研究为2020年8月至2021年7月期间开展的探索性横断面定量研究。数据收集采用线上问卷形式，通过电子邮件向学生发送自由知情同意书，在受试者签署并确认同意后，共纳入365名研究对象。数据分析采用EpiInfo软件（epi-info）完成：对定性变量采用相对频数与绝对频数进行描述，对定量变量采用位置与离散程度指标进行描述；同时采用卡方检验（chi-square test）进行统计学验证，显著性水平设定为5%。本研究严格遵循巴西国家研究伦理委员会第510/2016号决议的所有规范，并已获得该学院伦理委员会审批，审批编号为4228016。
研究结果：多数学生将死亡过程与痛苦、恐惧及悲伤情绪相关联，均认可毕业阶段开展死亡与临终主题讨论对临床诊疗工作及医师的社会心理福祉均具有积极影响。学生们普遍认为，毕业阶段中涉及死亡过程的教学极少开展，因此认为有必要增设相关课程以覆盖该主题。
研究结论：在医学毕业阶段开展死亡与临终相关主题讨论十分必要，建议在FPS的医学课程中增设相关教学模块，以帮助学生理解死亡与临终过程，并为其在从业过程中应对死亡事件做好心理准备。