Evidence map›Paper›PMID 27033962›Full record

ArticleBMJ open2016

Resident reflections on end-of-life education: a mixed-methods study of the 3 Wishes Project.

J Centofanti, M Swinton, J Dionne, A Barefah, A Boyle, A Woods, M Shears, D Heels-Ansdell, D Cook

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Educational interventions for training oncology residents in palliative medicine: a rapid review of the available evidence to inform training standards in cancer care.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

J CentofantiDepartment of Anesthesia, McMaster University, Hamilton, Ontario, Canada Department of Critical Care, McMaster University, Hamilton, Ontario, Canada.
M SwintonDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
J DionneDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
A BarefahDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
A BoyleDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada Department of Medicine and Critical Care, St. Joseph's Healthcare, Hamilton, Ontario, Canada.
A WoodsDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada Department of Medicine and Critical Care, St. Joseph's Healthcare, Hamilton, Ontario, Canada.
M ShearsDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
D Heels-AnsdellDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
D CookDepartment of Critical Care, McMaster University, Hamilton, Ontario, Canada Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada Department of Medicine, McMaster University, Hamilton, Ontario, Canada Department of Medicine and Critical Care, St. Joseph's Healthcare, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objectives of this study were to describe residents' experiences with end-of-life (EOL) education during a rotation in the intensive care unit (ICU), and to understand the possible influence of the 3 Wishes Project.

designWe enrolled dying patients, their families and 1-3 of their clinicians in the 3 Wishes Project, eliciting and honouring a set of 3 wishes to bring peace to the final days of a critically ill patient's life, and ease the grieving process for families. We conducted semistructured interviews with 33 residents who had cared for 50 dying patients to understand their experiences with the project. Interviews were recorded, transcribed verbatim, then analysed using a qualitative descriptive approach.

setting21-bed medical surgical ICU in a tertiary care, university-affiliated hospital.

results33 residents participated from internal medicine (24, 72.7%), anaesthesia (8, 24.2%) and laboratory medicine (1, 3.0%) programmes in postgraduate years 1-3. 3 categories and associated themes emerged. (1) EOL care is a challenging component of training in that (a) death in the ICU can invoke helplessness, (b) EOL education is inadequate, (c) personal connections with dying patients is difficult in the ICU and (d) EOL skills are valued by residents. (2) The project reframes the dying process for residents by (a) humanising this aspect of practice, (b) identifying that family engagement is central to the dying process, (c) increasing emotional responsiveness and (d) showing that care shifts, not stops. (3) The project offers experiential education by (a) intentional role modelling, (b) facilitating EOL dialogue, (c) empowering residents to care in a tangible way and (d) encouraging reflection.

conclusionsFor residents, the 3 Wishes Project integrated many forms of active learning for residents. Practice-based rather than classroom-based programmes may engage trainees to develop EOL skills transferable to other settings.

Indexed as

Internship and ResidencyAdultAgedAged, 80 and overAnesthesiaFemaleHumansIntensive Care UnitsInternal MedicineInterviews as TopicLaboratories, HospitalMaleMiddle AgedPhysiciansTerminal CareTertiary Care CentersMEDICAL ETHICS

Identifiers

PMID27033962
PMCPMC4823392

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.