Passing Away: An Exploratory Study into Physiotherapy Students' Experiences of Patient Death whilst on Clinical Placement

Abstract

Objectives: Physiotherapy students returning to university following clinical placement commonly reported encountering patient death and often appeared traumatised by the experience. This exploratory study focuses on three main areas: students' experiences of patient death, their feelings and how they coped.

Design: A qualitative research design utilised focus groups to explore students’ experiences of patient death. Sessions were audio-taped, transcribed verbatim and underwent independent thematic analysis by the authors. Categories and themes were then agreed.

Participants: Two consecutive final year cohorts were invited to participate in this qualitative study. This resulted in a purposive sample of 15 Physiotherapy students.

Findings: Five overlapping themes emerged: emotional distress, contrasts in reactions, desire to respond professionally, coping strategies and contextual risk factors. Students reported not only descriptions of the patient’s death but also the perceived contrast between their reactions and those of experienced staff. The latter were described as ‘insensitive’ and ‘blasé’. This contrast resulted in a breakdown in communication and a suppression of students’ reactions as they did not want to appear ‘silly’ or ‘unprofessional’.
There is increasing recognition that effective management of patient death is an important part of health care. This study suggests that if placement is to be an effective learning environment for this aspect of practice then established healthcare professionals and educators need to be positive role models. Without this the values and skills that are necessary for providing quality end-of-life care may struggle to develop, as well as the culture of openness and transparency that is essential so that students no longer feel they have to hide their emotional distress.