title: Coping with death and dying on a neurology inpatient service: death rounds as an educational initiative for residents.
abstract: BACKGROUND
  Residents in neurology may feel unprepared to care for dying patients. We developed Death Rounds to provide emotional support and end-of-life care teaching for residents caring for dying patients on the inpatient neurology service. Death Rounds are monthly 1-hour clinical case discussions where residents identify issues through shared experiences.
  
  
  OBJECTIVE
  To survey neurology residents' perceptions of Death Rounds with respect to end-of-life care teaching and emotional support. Design, Setting, and
  
  
  METHODS
  We conducted an electronic survey of all (n = 26) neurology residents and recent residency graduates at the University of Washington 2 years after instituting monthly Death Rounds. Main Outcome Measure  The survey consisted of 10 questions examining residents' perceptions of the extent to which Death Rounds provided emotional support and end-of-life care teaching. We dichotomized responses to statements about Death Rounds as agree or disagree.
  
  
  RESULTS
  All 26 residents responded to the survey and attended at least 1 Death Rounds session. More than half of residents attended more than 3 sessions. Residents agreed that Death Rounds helped them cope with dying patients (17 residents [65%]), delivered closure for the team (16 residents [61%]), and provided emotional support, more for the team (18 residents [69%]) than the individual (10 residents [38%]). Most residents felt that Death Rounds provided useful teaching about end-of-life care (18 residents [69%]), and they were satisfied overall with Death Rounds (16 residents [61%]).
  
  
  CONCLUSIONS
  Death Rounds afford an opportunity for physicians-in-training to process as a group their feelings, intense emotions, and insecurities while learning from the dying process. In our inpatient neurology service, most residents found it a rewarding and valuable experience.
authors.affiliation: Department of Neurology, University of Washington, 325 Ninth Ave, Box 359775, Seattle, WA 98104, USA. skhot@uw.edu
authors.forename: Sandeep
authors.initials: S
authors.lastname: Khot
authors.forename: Martha
authors.initials: M
authors.lastname: Billings
authors.forename: Darrell
authors.initials: D
authors.lastname: Owens
authors.forename: W T
authors.initials: WT
authors.lastname: Longstreth
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D002983:Clinical Competence; D003625:Data Collection / Q000379:methods; D006760:Hospitalization; D006801:Humans; D009462:Neurology / Q000193:education* / Q000379:methods; D010166:Palliative Care / Q000379:methods; D056164:Teaching Rounds / Q000379:methods; D013727:Terminal Care / Q000379:methods