• Gregory B Crawford and Sofia C Zambrano.
• Dr. Crawford is Mary Potter Associate Professor of Palliative Medicine, School of Medicine, University of Adelaide, and senior consultant in palliative medicine, Central Adelaide Local Health Network, Adelaide, South Australia, Australia. Dr. Zambrano is palliative care research officer, School of Medicine, University of Adelaide, and visiting research fellow, School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
• Acad Med. 2015 Mar 1;90(3):338-44.

PurposeTo explore how junior doctors (doctors in postgraduate training) retrospectively perceived the influence of their undergraduate palliative care attachments (clinical electives) on their current medical practice.MethodFrom 2008 to 2013, 100 students participated in palliative care attachments at the University of Adelaide School of Medicine. In 2013, the authors invited 14 of these, now junior doctors, to be in this study. Participants took part in one-on-one, semistructured interviews. Interview data were analyzed for themes.ResultsNine junior doctors participated. They were sent a summary of the findings to check whether the themes captured each participant's experiences. Eight replied and agreed. Two main themes were identified: (1) from apprehension to gaining a sense of control, and (2) gaining perspective on the practice of medicine. Participants perceived that the learning experiences from the attachments provided them with a sense of confidence and control over their interactions with dying patients and families. This positive influence not only was present when caring for patients at the end of life but also influenced the participants' identity as medical practitioners.ConclusionsFindings suggest that junior doctors trained earlier in palliative care have enhanced competencies of professionalism, patient-centered medicine, psychosocial and spiritual aspects of palliative care, communication, teamwork, and self-awareness. Learning a palliative approach can help them make a difference in treating dying patients, but also in general patient care. Therefore, physicians trained in palliative care may be better prepared to contribute to a health care system that is person-centered, ethically conscientious, and personally fulfilling.

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