Non-Physician Hospice and Palliative Staff: How Do They Describe Their Role in Medical Education?

Purpose Hospice and palliative teams are typically composed of chaplains, nurses, physicians, social workers, and others who provide interdisciplinary holistic care. These non‐physician staff may teach and role‐model aspects of patient care. This study explored how non‐physician hospice and palliative staff describe their role in teaching physicians‐in‐training. Methods Semi‐structured interviews were conducted of non‐physician hospice and palliative staff. All interviews were audio recorded and transcribed verbatim. Initial open coding by two researchers (AW, JR) identified the codes and then the constant comparative method was used to find patterns by axial coding, categories and themes within the data. Coding discrepancies were resolved through discussion. Member-checking was conducted by asking all participants to review the final list of themes. Results Six hospice and palliative medicine staff members participated in interviews. Participants included chaplains, nurses, a social worker, and a physician assistant. All of the participants have practiced their discipline for many years (14-35), yet were newer to the field of hospital and palliative medicine. Four of the participants are women. Five major themes were identified during content analysis: (1) finding a teaching role as an “informal” teacher, (2) using professional identity as a foundation for teaching, (3) teaching through experiential learning, debriefing, and role-modeling, (4) teaching to perceived gaps in physician training, (5) understanding the learning needs of physicians-in-training. Conclusion The non-physician staff interacted with physicians-in-training guided by their disciplinary skills and perspectives on patient care. Although they did not feel that they have formal teaching roles, they direct their teaching towards perceived gaps in physician training using reflection, dialogue and role modeling through. The rich learning environment provides for good informal learning through interprofessionality. Based on these results, we would argue that these non-physician staff should be considered teachers albeit informal and as such be targets of professional development. Future studies could explore the educational roles and perspectives of nonphysician professionals in other specialties and across diverse academic institutions.