The psychological effects of loss and grief in the general population have been well documented. More recently, there has been a focus on the impact of these experiences on healthcare professionals in particular. Below is a curated list of relevant scientific literature. If you are a student or educator who is interested in learning more about the underlying mechanisms of grief, the consequences of grief on medical trainees, and/or the current landscape of grief education in the medical field, we hope you will find it useful.
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Personal Reflections
Healthcare workers regularly care for the dying, but we rarely have the opportunity to hear them speak candidly on the subject. Below are a number of articles from medical students and physicians who have reflected on their personal and professional experiences with death and dying:
Antiel, R.M. (2011). A like sufferer. Journal of Palliative Medicine, 14(10), 1176-1177. DOI: 10.1089/jpm.2011.0116
Block, S.D., & Billings, J.A. (2005). Learning from the dying. New England Journal of Medicine, 353(13), 1313-1315. DOI: 10.1056/NEJMp048171
Charon R. (2017). To see the suffering. Academic Medicine: Journal of the Association of American Medical Colleges, 92(12),1668-1670. DOI: 10.1097/ACM.0000000000001989
Pradhan, S. (2016). Diary of a daughter. Indian Journal of Medical Ethics, 1(2),123. DOI: 10.20529/IJME.2016.033
Spencer, R. (2013). Portrait of an artist. Journal of the American Medical Association, 309(6), 557-558. DOI: 10.1001/jama.2012.217484
Vohra S. (2014). Learning not to move forward. Journal of the American Medical Association, 312(21), 2215–2216. DOI: 10.1001/jama.2014.12931
Bonales, V., & Himelstein, B. (2003). You grieve. Journal of Palliative Medicine, 6(5), 779-780. DOI: 10.1089/109662103322515338
Vallurupalli M. (2013). Mourning on morning rounds.New England Journal of Medicine, 369(5), 404-405. DOI: 10.1056/NEJMp1300969
Coping with Grief in Medicine
Learn more about the effects of bereavement on healthcare providers, as well as coping strategies that have been shown to be beneficial:
Allie, Z., Le Roux, E., Mahlatsi, K., Mofokeng, B., Ramoo, Z. A., Sibiya, K., … Brits, H. (2018). Bereavement overload and its effects on, and related coping mechanisms of health care providers and ward administrators at National District Hospital in Bloemfontein, Free State. African Journal of Primary Health Care & Family Medicine, 10(1), e1–e7. DOI: 10.4102/phcfm.v10i1.1652
Burns, L. (2017). Preparing medical schools for tragedy. Academic Medicine, 92(7), 899. DOI: 10.1097/ACM.0000000000001748
Greenstreet, W. (2005). Loss, grief and bereavement in interprofessional education, an example of process: anecdotes and accounts. Nurse Education in Practice, 5(5), 281-288. DOI: 10.1016/j.nepr.2005.02.003
Lohan, J.A. (2006). School nurses’ support for bereaved students: a pilot study. The Journal of School Nursing, 22(1), 48-52. DOI: 10.1177/10598405060220010801
Poultney, J., Wiserman, F., Waterhouse, E., & Faull, C. (2012). The impact on bereaved carers of being involved in medical student education. Palliative Medicine, 26(2), 185-186. DOI: 10.1177/0269216311415453
Robinson, D.O. (1978). The medical-student spouse syndrome: grief reactions to the clinical years. American Journal of Psychiatry, 135(8), 972-974. DOI: 10.1176/ajp.135.8.972
Sansone, R. A., & Sansone, L. A. (2012). Physician grief with patient death. Innovations in Clinical Neuroscience, 9(4), 22–26. PMID: 22666638
Vega, P.V., González, R., Bustos, J., Rojo, L., López, M.E., Rosas, A., & Hasbún, C.G. (2017). Relationship between grief support and burnout syndrome in professionals and technicians of pediatric health. Revista Chilena de Pediatría, 88(5), 614-621. DOI: 10.4067/S0370-41062017000500007
Weisskopf, S., & Binder, J.L. (1976). Grieving medical students: Educational and clinical considerations. Comprehensive Psychiatry, 17(5), 623-630. DOI: 10.1016/S0010-440X(76)80006-5
Whyte, R., Quince, T., Benson, J., Wood, D., & Barclay, S. (2013). Medical students' experience of personal loss: Incidence and implications. BMC medical education, 13, 36. DOI: 10.1186/1472-6920-13-36
Williams, C.M., Wilson, C.C., & Olsen, C.H. (2005). Dying, death, and medical education: Student voices. Journal of Palliative Medicine, 8(2), 372-381. DOI: 10.1089/jpm.2005.8.372
Death & Grief in Medical Education
A number of educational programs have been developed to formally teach medical students about death and grief:
Barton, D., Flexner, J.M., Van Eys, J., & Scott, C.E. (1972). Death and dying: A course for medical students. Journal of Medical Education, 47(12), 945-951. PMID: 4118165
Batley, N. J., Bakhti, R., Chami, A., Jabbour, E., Bachir, R., El Khuri, C., & Mufarrij, A. J. (2017). The effect of patient death on medical students in the emergency department. BMC Medical Education, 17(1), 110. DOI: 10.1186/s12909-017-0945-9
Black, D., Hardoff, D., & Nelki, J. (1989). Educating medical students about death and dying. Archives of Disease in Childhood, 64(5), 750–753. DOI: 10.1136/adc.64.5.750
Bleeker, J.A., Pomerantz, H.B. (1979). The influence of a lecture course in loss and grief on medical students: An empirical study of attitude formation. Medical Education, 13(2), 117-128. DOI: 10.1111/j.1365-2923.1979.tb00933.x
Bloomfield, J., O'Neill, B., & Gillett, K. (2015). Enhancing student communication during end-of-life care: A pilot study. Palliative and Supportive Care, 13(6), 1651-1661. DOI: 10.1017/S147895151500022
Branch W, Pels RJ, Lawrence RS, Arky R. (1993). Becoming a doctor: Critical-incident reports from third-year medical students. New England Journal of Medicine, 329(15):1130–1132. DOI: 10.1056/NEJM199310073291518
Broden, E.G., & Uveges, M.K. (2018). Applications of grief and bereavement theory for critical care nurses. AACN Advanced Critical Care, 29(3), 354-359. DOI: 10.4037/aacnacc2018595
Chen, J.Y., Chan, G.S., Tsang, J.P., & Tsang, G.K. (2016). The hospital mortuary: Learning about death…and life. Medical Education, 50(11), 1145-1146. DOI: 10.1111/medu.13201
Cherri D. Hobgood, Joshua H. Tamayo-Sarver, David W. Hollar Jr. & Susan Sawning (2009). Griev_Ing: Death notification skills and applications for fourth-year medical students, teaching and learning in medicine. Teaching and Learning in Medicine, 21(3), 207-219. DOI: 10.1080/10401330903018450
Dakin, C. (2003). Encouraging student nurses’ creative expression about end-of-life experiences. Nurse Educator, 28(4), 149-150. DOI: 10.1097/00006223-200307000-00001
Fuller J. (1999). Teaching medical students about bereavement is hard. BMJ (Clinical research ed.), 319(7216), 1071. DOI: 10.1136/bmj.319.7216.1071
Harding, D.J., & Southern, J. (1991). Using a community networking approach in a bereavement program. American Journal of Hospital and Palliative Medicine, 8(4), 20-22. DOI: 10.1177/104990919100800405
Jones, A. (1997). The Lead Lecture as an adjunct to experiential learning (an appropriate modality for the introduction of issues related to death, loss and change). European Journal of Cancer Care, 6(1), 32-39. DOI: 10.1111/j.1365-2354.1997.tb00266.x
Krueger D.W. (1979). Patient suicide: Model for medical student teaching and mourning. General Hospital Psychiatry, 1(3), 229–233. DOI: 10.1016/0163-8343(79)90023-9
Matzo, M., Sherman, D., Lo, K., Egan, K., Grant, M., & Rhome, A (2003). Strategies for teaching loss, grief, and bereavement. Nurse Educator, 28(2), 71-76. DOI: 10.1097/00006223-200303000-00009
L. McIlwaine, V. Scarlett, A. Venters & J. S. Ker (2007). The different levels of learning about dying and death: An evaluation of a personal, professional and interprofessional learning journey. Medical Teacher, 29:6, e151-e159, DOI: 10.1080/01421590701294331
Rosenbaum, M.E., Lobas, J., & Ferguson, K. (2005). Using reflection activities to enhance teaching about end-of-life care. Journal of Palliative Medicine, 8(6), 1186-1195. DOI: 10.1089/jpm.2005.8.1186
Serwint, J.R., Bostwick, S., Burke, A.E., Church, A., Gogo, A., Hofkosh, D., King, M., …, & Baldwin, C. (2016). The AAP Resilience in the Face of Grief and Loss curriculum. Pediatrics, 138(5), 1-9. DOI: 10.1542/peds.2016-0791
Stein, G., Berkman, C., & Pollak, B. (n.d.). What are social work students being taught about palliative care? Palliative and Supportive Care, 1-6. DOI: 10.1017/S1478951518001049
Woolsey, S.F. (1985). A medical school course in coping with death: An opportunity to consider some basic health care issues. Developmental and Behavioral Pediatrics, 6(2), 91-99. DOI: 10.1097/00004703-198504000-00008
Wright, P.M. (2011). Innovations in bereavement education. Journal of Nursing Education, 50(8), 476-478. DOI: 10.3928/01484834-20110415-02