Dataset Information

Teaching Medical Students About "The Conversation": An Interactive Value-Based Advance Care Planning Session.

ABSTRACT: Advance care planning (ACP) promotes care consistent with patient wishes. Medical education should teach how to initiate value-based ACP conversations.To develop and evaluate an ACP educational session to teach medical students a value-based ACP process and to encourage students to take personal ACP action steps.Groups of third-year medical students participated in a 75-minute session using personal reflection and discussion framed by The Conversation Starter Kit. The Conversation Project is a free resource designed to help individuals and families express their wishes for end-of-life care.One hundred twenty-seven US third-year medical students participated in the session.Student evaluations immediately after the session and 1 month later via electronic survey.More than 90% of students positively evaluated the educational value of the session, including rating highly the opportunities to reflect on their own ACP and to use The Conversation Starter Kit. Many students (65%) reported prior ACP conversations. After the session, 73% reported plans to discuss ACP, 91% had thought about preferences for future medical care, and 39% had chosen a medical decision maker. Only a minority had completed an advance directive (14%) or talked with their health-care provider (1%). One month later, there was no evidence that the session increased students' actions regarding these same ACP action steps.A value-based ACP educational session using The Conversation Starter Kit successfully engaged medical students in learning about ACP conversations, both professionally and personally. This session may help students initiate conversations for themselves and their patients.

SUBMITTER: Lum HD

PROVIDER: S-EPMC5730505 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Teaching Medical Students About "The Conversation": An Interactive Value-Based Advance Care Planning Session.

Lum Hillary D HD Dukes Joanna J Church Skotti S Abbott Jean J Youngwerth Jean M JM

The American journal of hospice & palliative care 20170303 2

<h4>Background</h4>Advance care planning (ACP) promotes care consistent with patient wishes. Medical education should teach how to initiate value-based ACP conversations.<h4>Objective</h4>To develop and evaluate an ACP educational session to teach medical students a value-based ACP process and to encourage students to take personal ACP action steps.<h4>Design</h4>Groups of third-year medical students participated in a 75-minute session using personal reflection and discussion framed by The Conve ...[more]

PMID: 28273761

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Project description:IntroductionThe session was designed as part of a yearlong elective within the Association of American Medical Colleges' Education in Pediatrics Across the Continuum (EPAC) pilot at the University of California, San Francisco. The EPAC pilot aims for longitudinal pediatric education across the medical school and pediatric residency years, with specific emphasis on competency-based advancement. The goal of the elective is to cultivate students' early interest in pediatrics.MethodsThis is an interactive case-based session for medical students on the clinical presentation and initial evaluation of adolescent depression. We developed this session based on an informal needs assessment at our local institution as well as prior research documenting the minimal time allocated to child and adolescent psychiatry in medical school curricula. The 80-minute interactive case-based format integrates knowledge and clinical experiences while requiring minimal equipment and preparation.ResultsThe session was administered at the University of California, San Francisco, in 2015 to 22 students. Fourteen participants completed evaluation questions (64% response rate). Of responders, 92%-100% thought the session was very or extremely effective at meeting the stated objectives, was interactive, had appropriate time allocated, and was very or extremely helpful at reinforcing objectives from the medical school curriculum. Thirteen participants completed postsession knowledge acquisition questions and performed better than controls (90% vs. 75%), but the difference was not statistically significant.DiscussionOther medical schools could easily administer this session as presented or adapt it to a different target audience or for different time constraints. It is an effective, interactive, well-paced, and helpful means of introducing to medical students a topic that is relevant for anyone going into pediatrics. Likewise, it helps to rectify the lack of child and adolescent psychiatry content in most medical school programs, and it aligns with the movement in undergraduate medical education towards more clinically integrated, inquiry-based curricula with attention to professional development.

Project description:BackgroundPalliative care (PC) is a strongly emerging discipline worldwide. Despite efforts to integrate this important topic in the medical curriculum in Belgium, still little time is spent on PC and its implementation during theoretical and practical training.Materials & methodsWe had two cohorts of second master's year MD students at the University of Antwerp complete a survey compromising a custom-built PC knowledge test and a self-confidence assessment of communicative skills used in end-of-life conversations. We evaluated students' self-confidence regarding end-of-life-conversations before and after a PC training program. We also explored whether the PC classes enabled the students to adequately reflect on factors that might influence end-of-life conversations with an open-end question about the potential implications of the COVID-19 pandemic on advance care planning (ACP) conversations. Finally, we compared the results of the respondents having enjoyed face-to-face training (cohort 1) with those having received online training only (cohort 2, COVID-19 pandemic).ResultsAlthough the respondents in both cohorts indicated that the overall curriculum did not pay enough attention to PC training, their average scores on the theoretical questions were good. Feeling confident about their communicative skills in general, they indicated to be less confident when it came to communications concerning PC and ACP in particular. The COVID-19 pandemic was initially equally deemed to impede and facilitate ACP and end-of-life conversations, but after the ACP training class more respondents saw the pandemic as an opportunity to broach end-of-life issues. Finally, we found no differences in scores between online and regular classroom teaching.ConclusionStudents experience a lack of confidence in communication skills used in end-of-life conversations and ACP. To help improve skills and competencies in conducting end-of-life conversations, it is recommended to have medical students assess PC/ACP training programs regularly and to modify the curriculum and course content based on these outcomes and current developments.

Dataset Information

Teaching Medical Students About "The Conversation": An Interactive Value-Based Advance Care Planning Session.

Publications

Teaching Medical Students About "The Conversation": An Interactive Value-Based Advance Care Planning Session.

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