Death certificates by general medical interns: quantitative and qualitative studies

The death certificate is the prerequisite for writing the death certificate. Many medical students have never been confronted with death when they observe a death for the first time. We conducted a prospective cohort study using an anonymous questionnaire coupled with a qualitative study using semi-directed interviews with general medicine interns at the Nancy faculty. The aim was to identify the difficulties encountered by the students in order to propose an adaptation of their studies. The students interviewed expressed both practical and emotional difficulties at the time of the death certificate. The practical difficulty was related to the fact of being alone, not knowing the deceased patient and feeling a strong emotional difficulty. This difficulty was significantly related to the performance of more complementary examinations. The average emotional difficulty was independent of the circumstances of the death certificate. The participants said they were particularly powerless to communicate with the family. These results lead us to propose the implementation of a specific training course on confrontation with death, for the attention of medical students. The use of simulation as a teaching tool seems appropriate. (c) 2022 Elsevier Masson SAS. All rights reserved.