Perception and attitudes of medical students toward communication, chronic disease and death

Baliram V. Ghodke, Ipseeta Ray-Mohanty, Abhay R. Wagh, Yashwant A. Deshmukh


Background: Medical students of today’s world found difficulty in communication when they faced with dying patients, how they would feel, what are their perception about caring of patients with chronic disease. These are often unspoken and neglected issues.

Methods: It was a cross-sectional comparative questionnaire based survey of the 2nd year medical students and interns. Students were evaluated using a questionnaire consisting of 15 Likert type statements.

Results: Completed questionnaire received from 89 out of 100 students. All students strongly agreed upon the commutation with patients. Interns (37.03%) were strongly disagreed (p=0.001) on not curing the patient is a failure of doctors. Interns (32.58%) were significantly more likely to be less worried (p<0.01) about death of the patient and to indicate cancer is a non-curable disease (p<0.001) when compared to 2nd MBBS. Students from both the groups distressed, while communicating with dying patients and relatives of dying patients.

Conclusion: Perception of students regarding caring of chronically ill-patients and death related issues needs improvement. We believe that integrating different teaching strategies and training programs regarding this issue should begin at early stages of undergraduate medical curriculum.


Communication, Death, Dying patients, Medical students

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Duffy FD, Gordon GH, Whelan G, Cole-Kelly K, Frankel R, Buffone N, et al. Assessing competence in communication and interpersonal skills: the Kalamazoo II report. Acad Med. 2004;79(6):495-507.

van Zanten M, Boulet JR, McKinley DW, DeChamplain A, Jobe AC. Assessing the communication and interpersonal skills of graduates of international medical schools as part of the United States Medical Licensing Exam (USMLE) Step 2 Clinical Skills (CS) Exam. Acad Med. 2007;82 10 Suppl: S65-8.

Brédart A, Bouleuc C, Dolbeault S. Doctor-patient communication and satisfaction with care in oncology. Curr Opin Oncol. 2005;17(4):351-4.

Brinkman WB, Geraghty SR, Lanphear BP, Khoury JC, Gonzalez del Rey JA, Dewitt TG, et al. Effect of multisource feedback on resident communication skills and professionalism: a randomized controlled trial. Arch Pediatr Adolesc Med. 2007;161(1):44-9.

Herndon JH, Pollick KJ. Continuing concerns, new challenges, and next steps in physician-patient communication. J Bone Joint Surg Am. 2002;84-A(2):309 15.

Royak-Schaler R, Gadalla S, Lemkau J, Ross D, Alexander C, Scott D. Family perspectives on communication with healthcare providers during end-of-life cancer care. Oncol Nurs Forum. 2006;33(4):753-60.

Lloyd-Williams M, Dogra N. Caring for dying patients – What are the attitudes of medical students? Support Care Cancer. 2003;11(11):696-9.

Lloyd-Williams M, Dogra N. Attitudes of preclinical medical students towards caring for chronically ill and dying patients: does palliative care teaching make a difference? Postgrad Med J. 2004;80(939):31-4.

Lloyd-Williams M, Dogra N, Petersen S. First year medical students’ attitudes towards patients with life-limiting illness: does age make a difference? Palliat Med. 2004;18(2):137-8.

Aull F. Telling and listening: constraints and opportunities. Narrative. 2005:13:281-93.

Zylicz Z, Janssens M.J.P. Options in palliative care: dealing with those who want to die. Baillière’s Clin Anaesthesiol. 1998:12(1):121-31.

Rakel RE, Storey P. Care of the dying patient. In: Rakel RE, editor. Textbook of Family Medicine. 5th Edition. Philadephia: W.B. Saunders Company; 1995: 134-51.

Curtis KK, Mcgee MG. An overview of physician attitudes toward death and dying: history, factors, and implications for medical education. Illn Crisis Loss. 2000:8(4):341-9.

Buckman R. Breaking bad news: why is it still so difficult? Br Med J (Clin Res Ed). 1984;288:1597-9.

Sullivan AM, Lakoma MD, Block SD. The status of medical education in end-of-life care: a national report. J Gen Intern Med. 2003;18(9):685-95.

Arora NK. Interacting with cancer patients: the significance of physicians’ communication behavior. Soc Sci Med. 2003;57(5):791-806.

Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995;152(9):1423 33.

Roter DL. Physician/patient communication: transmission of information and patient effects. Md State Med J. 1983;32(4):260-5.

Cleeland CS, Cleeland LM, Dar R, Rinehardt LC. Factors influencing physician management of cancer pain. Cancer. 1986;58(3):796-800.

Von Roenn JH, Cleeland CS, Gonin R, Hatfield AK, Pandya KJ. Physician attitudes and practice in cancer pain management. A survey from the Eastern Cooperative Oncology Group. Ann Intern Med. 1993;119(2):121-6.

Field D, Wee B. Preparation for palliative care: teaching about death, dying and bereavement in UK medical schools 2000-2001. Med Educ. 2002;36(6):561-7.

Buss MK, Marx ES, Sulmasy DP. The preparedness of students to discuss end-of-life issues with patients. Acad Med. 1998;73(4):418-22.

Sack WH, Fritz G, Krener PG, Sprunger L. Death and the pediatric house officer revisited. Pediatrics. 1984;73(5):676 81.

Billngs JA, Block S. Palliative care in undergraduate medical education. J Am Med Assoc. 1997:278:733-8.

Medical Council of India. Vision: 2015. March, 2011. Available at Accessed 23 Jul 2014.