• Michael Darmon, Guillaume Ducos, Isaline Coquet, Matthieu Resche-Rigon, Frederic Pochard, Marie Paries, Nancy Kentish-Barnes, Marine Chaize, Benoit Schlemmer, Elie Azoulay, and FAMIREA Study Group.
• Medical-Surgical Intensive Care Unit, Saint-Etienne University Hospital, Saint-Etienne, France. Electronic address: michael.darmon@chu-st-etienne.fr.
• Chest. 2016 Jul 1; 150 (1): 180-7.

BackgroundSurveys have highlighted perceived deficiencies among ICU residents in end-of-life care, symptom control, and confidence in dealing with dying patients. Lack of formal training may contribute to the failure to meet the needs of dying patients and their families. The objective of this study was to evaluate junior intensivists' perceptions of triage and of the quality of the dying process before and after formal academic training.MethodsFormal training on ethics was implemented as a part of resident training between 2007 and 2012. A cross-sectional survey was performed before (2007) and after (2012) this implementation. This study included 430 junior intensivists who were interviewed during these periods.ResultsMore responders attended a dedicated training course on ethics and palliative care during 2012 (38.5%) than during 2007 (17.4%; P < .0001). During 2012, respondents reported less discomfort and fewer uncertainties regarding decisions about limiting life-sustaining treatment (17.7% vs 39.1% in 2007; P < .0001) or the triage process (48.5% vs 69.4% in 2007; P < .0001). Factors independently associated with positive perceptions of the dying process were physician's age (OR, 1.19 per year; 95% CI, 1.09-1.25) and male sex (OR, 1.61; 95% CI, 1.05-2.47). Conversely, anxiety about family members' reactions (OR, 0.58; 95% CI, 0.0.37-0.87) and lack of training (OR, 0.29; 95% CI, 0.17-0.50) were associated with negative perceptions of this process.ConclusionsFormal training dedicated to ethics and palliative care was associated with a more comfortable perception of the dying process. This training may decrease the uncertainty and discomfort of junior intensivists in these situations.Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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