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PLoS One. 2019 Nov 27;14(11):e0224325. doi: 10.1371/journal.pone.0224325. eCollection 2019.

Being there: A scoping review of grief support training in medical education.

PloS one

Laura Sikstrom, Riley Saikaly, Genevieve Ferguson, Pamela J Mosher, Sarah Bonato, Sophie Soklaridis

Affiliations

  1. Office of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
  2. Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.
  3. Division of Child and Adolescent Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada.
  4. Division of Psychosocial Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
  5. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
  6. Departments of Psychiatry and Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
  7. Cross-appointed Scientist, Wilson Centre, University Health Network and Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

PMID: 31774815 PMCID: PMC6880967 DOI: 10.1371/journal.pone.0224325

Abstract

INTRODUCTION: Medical education experts argue that grief support training for physicians would improve physician and patient and family wellness, and should therefore be mandatory. However, there is little evidence about the range of curricula interventions or the impact of grief training. The aim of this scoping review was to describe the current landscape of grief training worldwide in medical school, postgraduate residency and continuing professional development in the disciplines of pediatrics, family medicine and psychiatry.

METHODS: Using Arksey and O'Malley's scoping review principles, MEDLINE, EMBASE, ERIC, PsychInfo and Web of Science were searched by a librarian. Two levels of screening took place: a title and abstract review for articles that fit a predefined criteria and a full-text review of articles that met those criteria. Three investigators reviewed the articles and extracted data for analysis. To supplement the search, we also scanned the reference lists of included studies for possible inclusion.

RESULTS: Thirty-seven articles published between 1979 and 2019 were analyzed. Most articles described short voluntary grief training workshops. At all training levels, the majority of these workshops focused on transmitting knowledge about the ethical and legal dimensions of death, dying and bereavement in medicine. The grief trainings described were characterized by the use of diverse pedagogical tools, including lectures, debriefing sessions, reflective writing exercises and simulation/role-play.

DISCUSSION: Grief training was associated with increased self-assessed knowledge and expertise; however, few of the studies analyzed the impact of grief training on physician and patient and family wellness. Our synthesis of the literature indicates key gaps exist, specifically regarding the limited emphasis on improving physicians' communication skills around death and dying and the limited use of interactive and self-reflexive learning tools. Most trainings also had an overly narrow focus on bereavement grief, rather than a more broadly defined definition of loss.

Conflict of interest statement

The authors have declared that no competing interests exist.

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