A comprehensive view to reflection on the palliative care approach for family medicine residents: A modified Delphi method

Abstract

Effective reflection is essential to allow family medicine residents to cope with difficult and negative experiences during palliative care. We developed a multidisciplinary, consensus-based comprehensive view to reflection on the palliative care approach for family medicine residents. We used a modified Delphi method and a multidisciplinary panel to build a systematic consensus. We developed a prototype comprehensive view based on a literature review, cognitive flexibility theory, and discussion by the research team. The 12 panelists consisted of 8 physicians, 3 nurses, and 1 medical social worker. The final comprehensive view consisted of 11 situations and 6 viewpoints regarding patterns of rapid and intermittent functional decline, respectively, with a total of 508 statements. Six of the 11 situations were common to both illness trajectories, and there were 5 unique situations for each disease trajectory. The 6 viewpoints were physical evaluation, mental/psychological evaluation, social evaluation, spiritual evaluation, cooperation among multidisciplinary professionals, and professional judgment. A comprehensive view to reflection on the palliative care approach was developed for family medicine residents using a modified Delphi method with multidisciplinary input. This comprehensive view may help family medicine residents and faculty become more reflective practitioners through interactive communication.

Keywords

• palliative care approach
• family medicine
• reflection
• modified delphi method
• cognitive flexibility theory