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Biomedical subjects

R D MacLeod

Publications and source records attributed to R D MacLeod.

At least 19 recordsLinked to original sources
PubMed2003

Early clinical exposure to people who are dying: learning to care at the end of life.

BACKGROUND: The nature of medical care at the end of life and, in particular, the way in which caring is learned remain problematic for medical educators and the profession. Recent work has indicated that doctors learn to care, in an emotional and intimate way, from people who are dying. METHODS: This paper reports on the development of a programme designed for medical students in their first clinical year who spend time with a person who is dying and their family. The students are required to produce a portfolio assignment that includes a personal reflection of the experience. The findings from a phenomenological study undertaken using these personal reflections are reported. These reflections and comments are interpreted as being embedded in five key themes. RESULTS: The actual encounters differed from the medical students' anticipation of them. Students identified an emotional component to the experience; they explored their own and the patient's understandings of spirituality; they reflected on personal meanings of the encounter and they suggested ways in which they might learn to care more effectively for people who are dying. DISCUSSION: The way in which many of these students approach end-of-life care has been altered through a transformative educational experience that encouraged them to draw on their own experiences and skills. Their learning was facilitated by the writing of accounts and the discussion that each group held with teaching staff at the conclusion of the programme.

Attitude to Death↗
PubMed2001

On reflection: doctors learning to care for people who are dying.

Humane care is an essential component of the doctor's role at the end of life. Over the last 20 years, there has been a steady global increase in the extent and variety of medical teaching about the care of people who are dying. In some countries, palliative medicine is now recognised as a discrete medical specialty. Rightly, much emphasis has been placed on symptom management, communication skills and ethical issues. But rarely does the concept of care, or how doctors learn to care, emerge in the medical literature. The concept of "care" is usually defined as a professional behaviour: attending to a patient's needs. Yet, the concept of care also requires a professional commitment on a more holistic level. To care is to be receptive to and responsible for others. This is care motivated by true empathy: a concern for the patient's well-being that comes from a sensitive identification with the patient's situation. This paper reports some of the findings from an interpretive phenomenological study involving 10 doctors and their experiences of learning to care for people who were dying. The doctors came from differing medical disciplines and had varying levels of experience. During the interviews the doctors retrospectively identified "turning points" at which they first perceived some notion of what it means to care for someone who is dying. The doctors often used poignant language when recollecting the strong feelings associated with these critical incidents. They felt that their training had been inadequate in preparing them for such care. The article asks whether their medical education had adequately prepared these doctors for this key element of their work. It recommends ways in which practitioners may be better prepared to care for people who are dying.

Attitude of Health Personnel↗
PubMed2000

Medical training.

Explore the source record for details and available documents.

Clinical Competence↗
PubMed1997

Improving the effectiveness of palliative care education.

Over the last three decades palliative care has emerged as a discrete specialty that has brought with it a developing field of education. Problematic areas have been identified within palliative care education that may limit its effectiveness. Areas of particular concern are identified that may prove obstructive in the pursuit of effectiveness in palliative care education. The possibility of developing performance indicators is explored with reference to the development of such indicators in other areas of education. Proposals are made as a starting point for the evolution of such indicators.

Education, Medical↗
PubMed1993

Teaching hospice medicine to medical students, house staff, and other caregivers in the United Kingdom.

This paper outlines the development of a medical education programme within the existing programme of the Macmillan Education Centre of the Dorothy House Foundation, Bath, England, between 1989 and 1992. A review of some of the significant contributions to the literature in this area is followed by a description of the initial research that was instrumental in designing these courses. A review of activities of the Centre is reported. A more detailed description of a course specifically designed for family doctors is made. A natural development from that course was one for all disciplines involved in caring for the terminally ill--this is described--along with some of the difficulties of such a method of education. Reference is made to evaluative work undertaken with reporting of initial data and work still in progress. Conclusions are drawn about the nature of such workshops and comment made on the role of facilitation.

Caregivers↗
PubMed1993

Education in palliative medicine: a review.

The development of the specialty of palliative medicine has produced variable activity in the field of medical education. This article reviews published papers (primarily from Europe but with reference to other countries) identifies the extent of activity, and notes the absence of evaluative work. Undergraduate and postgraduate activity is identified.

Hospice Care↗
PubMed1991

Teaching palliative care in general practice: a survey of educational needs and preferences.

We surveyed general practitioners in the Bath District Health Authority to determine their educational needs in palliative care and their preferred methods of learning, in order to develop an appropriate education program. The survey confirmed our ideas as to the content of the program. There was support for our hypothesis that the majority would favor didactic approaches and would feel generally uncomfortable with experiential methods. The issue of professionals' needs in stressful situations proved to be a surprisingly strong one.

Curriculum↗
PubMed1970

Evaluation of early diagnostic services for the elderly.

Medical examination was offered to a group of "high risk" old people who were not necessarily patients or known to their family doctors, but with the agreement of these family doctors. Two clinics set up for this purpose have been running for several years, and the results of examination and follow-up of 300 consecutive patients are reported.Major conditions were found in two-thirds of patients producing functional impairment in most of these.Recommendations as to therapy and management were carried out in 161 of 194 patients but not in the remainder.Clear evidence of improvement was found in half of the patients who carried out recommendations, and this improvement was attributable to earlier diagnosis than would have been achieved without these clinics in 42% of cases.Including all patients examined, the proportion helped by early diagnosis at 18 to 30 months' follow-up was 23%.It is concluded that the offer of a routine examination to high risk groups is of benefit to old people and a form of medical practice which should be widely adopted.

Aged↗