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Doctors’ learning experiences in end-of-life care – a focus group study from nursing homes

Overview of attention for article published in BMC Medical Education, January 2017
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Title
Doctors’ learning experiences in end-of-life care – a focus group study from nursing homes
Published in
BMC Medical Education, January 2017
DOI 10.1186/s12909-017-0865-8
Pubmed ID
Authors

Anette Fosse, Sabine Ruths, Kirsti Malterud, Margrethe Aase Schaufel

Abstract

Doctors often find dialogues about death difficult. In Norway, 45% of deaths take place in nursing homes. Newly qualified medical doctors serve as house officers in nursing homes during internship. Little is known about how nursing homes can become useful sites for learning about end-of-life care. The aim of this study was to explore newly qualified doctors' learning experiences with end-of-life care in nursing homes, especially focusing on dialogues about death. House officers in nursing homes (n = 16) participated in three focus group interviews. Interviews were audiotaped and transcribed verbatim. Data were analysed with systematic text condensation. Lave & Wenger's theory about situated learning was used to support interpretations, focusing on how the newly qualified doctors gained knowledge of end-of-life care through participation in the nursing home's community of practice. Newly qualified doctors explained how nursing home staff's attitudes taught them how calmness and acceptance could be more appropriate than heroic action when death was imminent. Shifting focus from disease treatment to symptom relief was demanding, yet participants comprehended situations where death could even be welcomed. Through challenging dialogues dealing with family members' hope and trust, they learnt how to adjust words and decisions according to family and patient's life story. Interdisciplinary role models helped them balance uncertainty and competence in the intermediate position of being in charge while also needing surveillance. There is a considerable potential for training doctors in EOL care in nursing homes, which can be developed and integrated in medical education. This practice based learning arena offers newly qualified doctors close interaction with patients, relatives and nurses, teaching them to perform difficult dialogues, individualize medical decisions and balance their professional role in an interdisciplinary setting.

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The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 183 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 183 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 37 20%
Student > Bachelor 16 9%
Researcher 15 8%
Unspecified 11 6%
Student > Ph. D. Student 11 6%
Other 35 19%
Unknown 58 32%
Readers by discipline Count As %
Nursing and Health Professions 38 21%
Medicine and Dentistry 31 17%
Social Sciences 20 11%
Unspecified 11 6%
Psychology 3 2%
Other 16 9%
Unknown 64 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 March 2017.
All research outputs
#13,736,647
of 23,881,329 outputs
Outputs from BMC Medical Education
#1,687
of 3,576 outputs
Outputs of similar age
#208,638
of 424,396 outputs
Outputs of similar age from BMC Medical Education
#29
of 49 outputs
Altmetric has tracked 23,881,329 research outputs across all sources so far. This one is in the 41st percentile – i.e., 41% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,576 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.4. This one has gotten more attention than average, scoring higher than 51% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 424,396 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.
We're also able to compare this research output to 49 others from the same source and published within six weeks on either side of this one. This one is in the 42nd percentile – i.e., 42% of its contemporaries scored the same or lower than it.