A novel advance directives course provides a transformative learning experience for medical students.

Abstract:

BACKGROUND:Inadequate physician training may be a barrier to physician-patient discussions of advance directives (ADs). DESCRIPTION:The purpose of this study was to determine the effects of an ADs course, which includes completing a directive, on medical students' perceived knowledge of and preparedness for discussing ADs with patients. All 4th-year medical students completed a 10-hr bioethics course comprising interactive lecture and small-group discussion formats. Curriculum content included ethical and legal aspects of ADs. An 8-item survey with free-text entry was administered 1 month after course completion. Internal consistency reliability of survey scores was determined. Two authors independently coded the free-text comments and reached consensus on underlying themes. EVALUATION:Of the 89 students who completed the survey (response rate 80%), 87 (98%) felt more knowledgeable and 88 (99%) better equipped to counsel patients about ADs. Forty-two (47%) reported they had counseled others to complete ADs during the month after the course. Internal consistency reliability of survey scores was very good (Cronbach's alpha =.78). Dominant themes of responses to the question, "What was the most eye opening, troubling, or difficult aspect about filling out your advance directive?" included difficulties articulating wishes, legal language, selecting a surrogate, and facing mortality. CONCLUSIONS:These findings suggest an ADs course that includes completing a directive enhances medical students' empathy for and preparedness to discuss ADs with patients.

journal_name

Teach Learn Med

authors

Mueller PS,Litin SC,Hook CC,Creagan ET,Cha SS,Beckman TJ

doi

10.1080/10401331003656678

subject

Has Abstract

pub_date

2010-04-01 00:00:00

pages

137-41

issue

2

eissn

1040-1334

issn

1532-8015

pii

920535782

journal_volume

22

pub_type

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