Learning from Legacy: A Thematic Analysis of Medical Students’ Experiences with Legacy Project Involvement

BACKGROUND: Encounters with death prove challenging for medical students. Typical clinical rotations are goal-oriented and offer limited opportunity to debrief emotions that arise during end-of-life (EOL) care. Encounters with real patients, in nonclinical contexts, with opportunity for self-reflection can enhance EOL learning, with some studies suggesting that direct patient encounters facilitate greater skill acquisition than didactic teaching. OBJECTIVES: 1.Explore medical students' comfort in working with patients nearing EOL, and whether supporting a patient in completing a legacy project improves confidence and skillset.2.Assess impacts of project participation on student well-being.3.Determine whether participation provides learning opportunities distinct from standard medical curriculum. DESIGN: Following completion of a legacy project with a patient, medical students at the University of British Columbia submitted a reflection on the experience. Reflexive thematic analysis was used to generate themes from nine of these reflections. RESULTS: Five themes were generated: 1."Death is not a topic I have a lot of experience with."2."I was able to learn from their wisdom."3."I worried…"4."By understanding their fears, likes, dislikes…I understood them as a person."5."I think I will become a better future doctor because of it." CONCLUSIONS: Students identified gaps in their professional development and saw legacy project participation as a means of addressing them. While participation involved logistical and emotional challenges, it contributed to professional and personal development and helped students understand patients as people outside of a medicalized context. Participation contributed to the development of physician identity.