Residents' learning from decision-making regarding critically ill elderly patients: / 医学教育

ABSTRACT

<p>Introduction: In Japanese emergency departments, many physicians have to decide immediately whether they should limit life-sustaining treatments for critically ill elderly patients who may be at their end-of-life (EOL) or in cardiopulmonary arrest. To propose effective medical training, we investigated the ability of junior residents to recognize this challenging problem.</p><p>Method: We conducted a semi-structured interview of 38 junior residents who had completed the junior residency program of University Hospital, Kyoto Prefectural University of Medicine. We then qualitatively analyzed the transcripts of the interviews.</p><p>Results: Through observation of the attending physician's interview, which is a discussion about decision-making with the patients and their families, junior residents recognized the problem of EOL and made their decision. Finally, they preferred "doctor-led discussion" or "neutral discussion."</p><p>Discussion: We recommend that attending physicians should give junior residents many opportunities to observe their interview about decision-making.</p>