From the Florida International University Herbert Wertheim College of Medicine, and the University of Miami/Jackson Memorial Hospital Program, Miami, Florida.
South Med J. 2022 May;115(5):290-293. doi: 10.14423/SMJ.0000000000001385.
The Liaison Committee on Medical Education requires that the curriculum of medical schools includes end-of-life care. Most medical students feel reluctant to discuss end-of-life issues with their patients, but would like to learn more.
We created an educational session on using Five Wishes to facilitate the advance care planning conversation. Third- and fourth-year students were given a brief PowerPoint lecture detailing the importance of advance directives, barriers to advance care planning conversations, approaches for the conversation, and two brief video sample conversations. Students discussed their experiences related to advance directives and role-played a part of an advance care planning conversation.
A total of 97 medical students participated in the didactic on advance care planning conversations from May 4, 2020 to October 24, 2020. Eighty-six (88.7%) of 97 students responded to the postcourse evaluation survey. Most of the respondents (96%) agreed or strongly agreed that the session was pertinent to learning needs and that the goals and objectives of the session were met. Ninety-two percent of respondents felt confident about having a conversation with a patient about advance directives and 88% of respondents felt comfortable starting and completing advance directives conversations.
The brief didactic presented here on facilitating advance directives conversations constitutes an easily implemented and well-received session for medical students. Students reported high levels of confidence and comfort around having advance directive conversations after participating in this didactic session.
医学教育联络委员会要求医学院的课程包括临终关怀。大多数医学生都不愿意与患者讨论临终问题，但希望能更多地了解相关内容。
我们创建了一个关于使用“五个愿望”来促进预先护理计划对话的教育环节。三、四年级学生接受了简短的 PowerPoint 讲座，详细介绍了预先指示的重要性、预先护理计划对话的障碍、对话的方法以及两个简短的视频样例对话。学生们讨论了他们与预先指示相关的经验，并进行了预先护理计划对话的角色扮演。
共有 97 名医学生参加了 2020 年 5 月 4 日至 10 月 24 日的预先护理计划对话教学。97 名学生中有 86 名（88.7%）对课后评估调查做出了回应。大多数受访者（96%）同意或强烈同意该课程与学习需求相关，并且该课程的目标和目的得到了满足。92%的受访者对与患者就预先指示进行对话有信心，88%的受访者对开始和完成预先指示对话感到舒适。
这里提出的关于促进预先指示对话的简短教学内容对于医学生来说是一个易于实施且广受欢迎的课程。学生们在参加这个教学环节后，报告在进行预先指令对话时信心和舒适度都很高。
