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Advance Care Planning

A Collaborative educational intervention to improve pre-clinical medical student confidence with Advance Care Planning (ACP)

, &
Pages 71-81
Published online: 04 May 2019

ABSTRACT

Background: Advance care planning (ACP) is an essential skill for clinicians, yet trainees feel inadequately prepared to conduct ACP discussions. Optimal teaching methods and timing are unknown.

Aim: We designed a curricular intervention to expose second-year medical students to the process of ACP, aiming to improve their ACP knowledge and confidence.

Design: The intervention consisted of a case-based workshop facilitated by a physician experienced in ACP (“facilitated ACP workshop”), which was added to an existing multifaceted ACP curriculum (longitudinal senior mentor program including multiple visits with a volunteer older adult, completion of an electronic ACP learning module and reflective writing exercise). The control group received the existing ACP curriculum only, while the intervention group received the existing curriculum plus the facilitated ACP workshop. Both groups completed an ACP knowledge assessment and confidence survey at the conclusion of the curriculum.

Setting/Participants: Two consecutive classes of second year medical students, single academic hospital.

Results: No statistically significant differences in ACP knowledge or confidence were seen post-intervention. Overall confidence with ACP tasks remained relatively low despite a multifaceted ACP curriculum.

Conclusions: Future studies should investigate longitudinal, experiential ACP learning, and seek to optimize ACP teaching strategies and timing.

Circle all that apply and underline the item that you feel is the biggest barrier

a. Not enough time to complete the documents

b. Not enough knowledge about this topic

c. Health-care provider did not recommend this to the patient

d. The written materials are too difficult for the patient to understand

e. Patients do not want to think about this topic

f. Patients feel that since they are healthy, they do not need an advance directive

g. Religious/cultural values and preferences

h. Patient feels that his/her doctor/family members would “know what I would want.”

i. Patient is not sure what his/her wishes are

j. This topic is to depressing/anxiety provoking for the patient.

k. Patient doesn’t want to upset family members by talking to them about this topic

l. Other:___________________________________________________

Additional information

Funding

Supported by Mayo Clinic Center for Clinical and Transitional Sciences (CCaTS) grant number UL1TR000135.

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