Bp Verdoorn, Mt Wingo, Ee Tung
Division of Community Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
Gerontol Geriatr Educ. 2021 Jan-Mar;42(1):71-81. doi: 10.1080/02701960.2019.1611570. Epub 2019 May 4.
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.
We designed a curricular intervention to expose second-year medical students to the process of ACP, aiming to improve their ACP knowledge and confidence.
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.
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.
Future studies should investigate longitudinal, experiential ACP learning, and seek to optimize ACP teaching strategies and timing.
预先护理计划(ACP)是临床医生的一项基本技能,但实习生感觉没有充分准备好进行ACP讨论。最佳教学方法和时机尚不清楚。
我们设计了一项课程干预措施,让二年级医学生接触ACP流程,旨在提高他们的ACP知识和信心。
干预措施包括由一位在ACP方面经验丰富的医生主持的基于案例的研讨会(“引导式ACP研讨会”),该研讨会被添加到现有的多方面ACP课程中(纵向高级导师计划,包括多次拜访一名老年志愿者、完成一个电子ACP学习模块和反思性写作练习)。对照组仅接受现有的ACP课程,而干预组接受现有的课程加上引导式ACP研讨会。两组在课程结束时都完成了一次ACP知识评估和信心调查。
背景/参与者:连续两届二年级医学生,单一学术医院。
干预后,在ACP知识或信心方面未发现统计学上的显著差异。尽管有一个多方面的ACP课程,但对ACP任务的总体信心仍然相对较低。
未来的研究应该调查纵向的、体验式的ACP学习,并寻求优化ACP教学策略和时机。