title: From cure to care: assessing the ethical and professional learning needs of medical learners in a care-based facility.
abstract: The purpose of this study was to assess the ethical and professional learning needs of medical trainees on clinical placements at a care-based facility, as they shifted from acute care to care-based philosophy. Using qualitative data analysis and grounded theory techniques, 12 medical learners and five clinical supervisors were interviewed. Five themes emerged as learning needs: the holistic approach to care, withdrawal of treatment and withholding investigations, the collaborative team model, violations to patient autonomy, Do Not Resuscitate and advance directives issues. The results illustrate the importance of preparing medical learners for a philosophical shift in their approach to patient care, as they move from the more cure-based approach of acute care to the care model of care-based facilities.
authors.affiliation: Division of Palliative Medicine, Bruyère Continuing Care, Ottawa, Ontario, Canada. phall@bruyere.org
authors.forename: Pippa
authors.initials: P
authors.lastname: Hall
authors.forename: Jane
authors.initials: J
authors.lastname: O'Reilly
authors.forename: Sue
authors.initials: S
authors.lastname: Dojeiji
authors.forename: Richard
authors.initials: R
authors.lastname: Blair
authors.forename: Anne
authors.initials: A
authors.lastname: Harley
mesh_terms: D000328:Adult; D016223:Advance Directives / Q000941:ethics; D003695:Delivery of Health Care / Q000941:ethics*; D004501:Education, Medical / Q000379:methods*; D004992:Ethics, Medical / Q000193:education*; D005260:Female; D006694:Holistic Health; D006801:Humans; D007407:Interviews as Topic; D007858:Learning; D008134:Long-Term Care / Q000941:ethics; D008297:Male; D020380:Needs Assessment; D010166:Palliative Care / Q000941:ethics; D010348:Patient Care Team / Q000941:ethics; D026684:Personal Autonomy; D010686:Philosophy, Medical; D013727:Terminal Care / Q000941:ethics; D028761:Withholding Treatment / Q000941:ethics