Abstract:
INTRODUCTION:Most medical schools are remiss in preparing physicians in end-of-life communication skills. As a result, many residents are uncomfortable with approaching the patient, have not developed the skills required to discuss the patients' wishes, and avoid end-of-life conversations. OBJECTIVE:To evaluate an educational intervention focused on teaching residents skills to discuss advance directives. METHODS:Medicine Residents attended a morning report consisting of both didactic training and participation in a role-play exercise. Charts of inpatients were audited ten days prior to and five days subsequent to the intervention to ascertain if there was a documented do-not-resuscitate (DNR) discussion. RESULTS:Seventy-nine records of patients assigned to eight physicians who attended the intervention and who were responsible for patients before and after the intervention were reviewed. Of the patients assigned to these residents before the intervention, 32% had a documented DNR discussion. Thirty-four (34%) of the physicians had discussions after the intervention, demonstrating only minimal improvement. CONCLUSIONS:A single intervention may be inadequate to affect physician practices related to DNR discussions. Physicians may need more interactive, experiential learning opportunities and related supervision over the course of their training in order to improve these communication skills. A chart review that only records if a DNR discussion was documented in the medical record may not be the best tool to evaluate the success of this educational intervention. Improvement in attitudes and knowledge were not able to be measured.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Furman CD,Head B,Lazor B,Casper B,Ritchie CSdoi
10.1089/jpm.2006.9.964subject
Has Abstractpub_date
2006-08-01 00:00:00pages
964-7issue
4eissn
1096-6218issn
1557-7740journal_volume
9pub_type
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pub_type: 杂志文章,随机对照试验
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更新日期:2010-10-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2012-07-01 00:00:00
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doi:10.1089/109662103768253696
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pub_type: 杂志文章,多中心研究
doi:10.1089/jpm.2014.0023
更新日期:2014-08-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2016-03-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2010-05-01 00:00:00
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更新日期:2015-10-01 00:00:00
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更新日期:2010-12-01 00:00:00
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更新日期:2017-10-01 00:00:00
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更新日期:2020-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1089/jpm.2017.0395
更新日期:2018-01-01 00:00:00
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更新日期:2013-04-01 00:00:00
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