On 2016 Mar 16, Cicely Saunders Institute Journal Club commented:

The Cicely Saunders Institute journal club reviewed this paper on Wednesday 3rd February 2016. We enjoyed discussing it and felt that the authors had addressed an important and understudied area of medical training. On the one hand, it is recognised that junior doctors increasingly need to be able to interact with terminally ill and other vulnerable groups of patients who need specialist palliative care and rehabilitation. On the other hand, there can be a common perception that it is unethical or unnecessary to involve the terminally ill in medical student teaching.

To investigate this issue in greater depth, the authors’ objective was to review available literature on how terminally ill patients feel about being involved in undergraduate medical teaching. Results were presented on a PRISMA flow chart, and studies appraised using a quality scoring system.

We felt that the paper would have been improved by the inclusion of clearer aims. The focus on patients’ views was interesting, and we wondered if the authors had considered extending this to include family perspectives.

Future studies could take the question beyond ‘should we involve terminally ill patients’ to ‘how and when’ it might be more or less acceptable to involve terminally ill patients in undergraduate medical education. Our discussions also considered whether this question could be extended to other life-limiting populations, such as people with complex neurological conditions, and to other cultures, where health systems and beliefs differ from the UK NHS system.

Commentary by Sophie Pask and Diana Jackson

On 2016 Mar 16, Cicely Saunders Institute Journal Club commented:

The Cicely Saunders Institute journal club reviewed this paper on Wednesday 3rd February 2016. We enjoyed discussing it and felt that the authors had addressed an important and understudied area of medical training. On the one hand, it is recognised that junior doctors increasingly need to be able to interact with terminally ill and other vulnerable groups of patients who need specialist palliative care and rehabilitation. On the other hand, there can be a common perception that it is unethical or unnecessary to involve the terminally ill in medical student teaching.

To investigate this issue in greater depth, the authors’ objective was to review available literature on how terminally ill patients feel about being involved in undergraduate medical teaching. Results were presented on a PRISMA flow chart, and studies appraised using a quality scoring system.

We felt that the paper would have been improved by the inclusion of clearer aims. The focus on patients’ views was interesting, and we wondered if the authors had considered extending this to include family perspectives.

Future studies could take the question beyond ‘should we involve terminally ill patients’ to ‘how and when’ it might be more or less acceptable to involve terminally ill patients in undergraduate medical education. Our discussions also considered whether this question could be extended to other life-limiting populations, such as people with complex neurological conditions, and to other cultures, where health systems and beliefs differ from the UK NHS system.

Commentary by Sophie Pask and Diana Jackson