Clinical experiences of medical students in Oregon with dying patients

Background. In Oregon only 31% of patients now die in acute care hospitals. This transformation carries profound implications for undergraduate medical education. Methods. Students graduating from Oregon Health Sciences University between 1996 and 1998 were surveyed regarding their direct clinical involvement in the care of dying patients. Results. Students had cared for substantial numbers of dying patients, and nearly all had participated in important advance planning discussions. However, student involvement had diminished markedly towards the latter stages of dying. Forty-five percent of the students had cared for two or fewer patients who died while still in the hospital. Even when patients died in the hospital, the students had rarely been present at the bedside at the time of patient death. Forty-two percent of the students had graduated having never witnessed a patient death. Conclusions. The findings highlight the need to create opportunities for students to care for dying patients in settings outside the acute care hospital.