Documentary Effects on Medical Student Attitudes & Skills Regarding Nutrition at the End of Life

Abstract

Medical trainees rarely have the opportunity to provide comprehensive end of life care or see the physical transformation of the dying process. Studies suggest that the use of film in medical education is an effective means of exposing students to aspects of medicine they might not otherwise receive. Dying Wish is a visual instrumental case study of a patient with end-stage cancer who chose to stop eating and drinking at the end of his life. In this randomized, controlled study, we assessed the impact of Dying Wish on medical students’ attitudes, knowledge, and confidence in patient/family discussions surrounding nutrition at the end of life using student surveys and independently validated standardized patient assessments. By the middle of the first clinical year, about 58% of students witnessed and 38.6% actively participated in a discussion regarding nutrition at the end of life with a patient and/or their family. Although there was no significant difference in students’ self-perceived knowledge or skills, a significantly higher percentage of students who viewed “ Dying Wish ” prior to standardized patient visits clearly explained the biological consequences of stopping eating and drinking compared to those who had not viewed the film. Students agreed that “ Dying Wish ” improved their knowledge of the physical effects of stopping eating and drinking and effectively introduced the ethical and psychosocial issues associated with nutrition at the end of life. Documentaries are considered by students to be effective teaching tools and “ Dying Wish ” represents a feasible way to deliver instruction regarding nutrition at the end of life. Visual depictions and documentary films that portray the natural courses of illnesses may prove to be helpful, efficient teaching tools and their role in the educational process for healthcare providers should continue to be studied.