title: Medical Students' Professionalism Narratives Reveal That Experiences With Death, Dying, or Palliative Care Are More Positive Than Other Experiences During Their Internal Medicine Clerkship.
abstract: More physicians need to acquire the skills of primary palliative care. Medical students' clerkship experiences with death, dying, and palliative care (DDPC), however, may create barriers to learning such skills during residency. Whether professional development is differentially affected by DDPC is unknown. This knowledge gap potentially hinders the development of educational strategies to optimize students' preparedness for primary palliative care.
  
  
  
  Third-year students submitted professionalism narratives (N = 4062) during their internal medicine clerkship between 2004 and 2011. We identified DDPC-related narratives and then randomly selected control narratives. Narratives were compared by valence (positive or negative) and professionalism-related themes.
  
  
  
  Less than 10% of the narratives were related to DDPC, but the majority was positive. There was a significant overlap in professionalism themes between DDPC and control narratives. The results suggest student preparedness for primary palliative care may be improved by addressing the common professionalism challenges of clinical clerkships.
authors.affiliation: 1 Department of Medicine, IU School of Medicine, Indianapolis, IN, USA.|2 IU Simon Cancer Center, Indianapolis, IN, USA.
authors.forename: Larry D
authors.initials: LD
authors.lastname: Cripe
authors.affiliation: 1 Department of Medicine, IU School of Medicine, Indianapolis, IN, USA.|2 IU Simon Cancer Center, Indianapolis, IN, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Hedrick
authors.affiliation: 2 IU Simon Cancer Center, Indianapolis, IN, USA.|3 Department of Psychology, IUPUI School of Science, Indianapolis, IN, USA.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Rand
authors.affiliation: 2 IU Simon Cancer Center, Indianapolis, IN, USA.|4 Department of Music and Arts Technology, Purdue School of Engineering and Technology at IUPUI, Indianapolis, IN, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Burns
authors.affiliation: 3 Department of Psychology, IUPUI School of Science, Indianapolis, IN, USA.
authors.forename: Daniella
authors.initials: D
authors.lastname: Banno
authors.affiliation: 1 Department of Medicine, IU School of Medicine, Indianapolis, IN, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Cottingham
authors.affiliation: 1 Department of Medicine, IU School of Medicine, Indianapolis, IN, USA.|5 Regenstrief Institute, Indianapolis, IN, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Litzelman
authors.affiliation: 1 Department of Medicine, IU School of Medicine, Indianapolis, IN, USA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Hoffmann
authors.affiliation: 5 Regenstrief Institute, Indianapolis, IN, USA.
authors.forename: Nora
authors.initials: N
authors.lastname: Martenyi
authors.affiliation: 1 Department of Medicine, IU School of Medicine, Indianapolis, IN, USA.|5 Regenstrief Institute, Indianapolis, IN, USA.|6 Roudebush Veterans Administration Medical Center, Indianapolis, IN, USA.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Frankel
mesh_terms: D001291:Attitude of Health Personnel; D002982:Clinical Clerkship; D003643:Death; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D033262:Narration; D010166:Palliative Care / Q000523:psychology; D000068616:Professionalism; D013337:Students, Medical / Q000523:psychology*
keywords: death; dying; end-of-life care; palliative care; professionalism; undergraduate medical education