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Published in: Journal of Cancer Education 1/2011

01-03-2011

Teaching Advance Care Planning to Medical Students with a Computer-Based Decision Aid

Authors: Michael J. Green, Benjamin H. Levi

Published in: Journal of Cancer Education | Issue 1/2011

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Abstract

Discussing end-of-life decisions with cancer patients is a crucial skill for physicians. This article reports findings from a pilot study evaluating the effectiveness of a computer-based decision aid for teaching medical students about advance care planning. Second-year medical students at a single medical school were randomized to use a standard advance directive or a computer-based decision aid to help patients with advance care planning. Students' knowledge, skills, and satisfaction were measured by self-report; their performance was rated by patients. 121/133 (91%) of students participated. The Decision-Aid Group (n = 60) outperformed the Standard Group (n = 61) in terms of students´ knowledge (p < 0.01), confidence in helping patients with advance care planning (p < 0.01), knowledge of what matters to patients (p = 0.05), and satisfaction with their learning experience (p < 0.01). Likewise, patients in the Decision Aid Group were more satisfied with the advance care planning method (p < 0.01) and with several aspects of student performance. Use of a computer-based decision aid may be an effective way to teach medical students how to discuss advance care planning with cancer patients.
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Literature
1.
go back to reference Doukas DJ, Brody H (1992) After the Cruzan case: the primary care physician and the use of advance directives. J Am Board Fam Pract 5:201–205PubMed Doukas DJ, Brody H (1992) After the Cruzan case: the primary care physician and the use of advance directives. J Am Board Fam Pract 5:201–205PubMed
2.
3.
go back to reference Miles S, Koepp R, Weber E (1996) Advance end-of-life treatment planning. Arch Intern Med 156:1062–1068CrossRefPubMed Miles S, Koepp R, Weber E (1996) Advance end-of-life treatment planning. Arch Intern Med 156:1062–1068CrossRefPubMed
4.
go back to reference Moskop JC (2004) Improving care at the end of life: how advance care planning can help. Palliat Support Care 2:191–197CrossRefPubMed Moskop JC (2004) Improving care at the end of life: how advance care planning can help. Palliat Support Care 2:191–197CrossRefPubMed
5.
go back to reference Mullan PB, Weissman DE, Ambuel B, von Gunten C (2002) End-of-life care education in internal medicine residency programs: an interinstitutional study. J Palliat Med 5:487–496CrossRefPubMed Mullan PB, Weissman DE, Ambuel B, von Gunten C (2002) End-of-life care education in internal medicine residency programs: an interinstitutional study. J Palliat Med 5:487–496CrossRefPubMed
6.
go back to reference Prendergast TJ (2001) Advance care planning: pitfalls, progress, promise. Crit Care Med 29:N34–N39CrossRefPubMed Prendergast TJ (2001) Advance care planning: pitfalls, progress, promise. Crit Care Med 29:N34–N39CrossRefPubMed
7.
go back to reference Schwartz CE, Merriman MP, Reed GW, Hammes BJ (2004) Measuring patient treatment preferences in end-of-life care research: applications for advance care planning interventions and response shift research. J Palliat Med 7:233–245CrossRefPubMed Schwartz CE, Merriman MP, Reed GW, Hammes BJ (2004) Measuring patient treatment preferences in end-of-life care research: applications for advance care planning interventions and response shift research. J Palliat Med 7:233–245CrossRefPubMed
8.
go back to reference Tulsky JA (2005) Beyond advance directives: importance of communication skills at the end of life. JAMA 294:359–365CrossRefPubMed Tulsky JA (2005) Beyond advance directives: importance of communication skills at the end of life. JAMA 294:359–365CrossRefPubMed
9.
go back to reference Emanuel LL, Emanuel EJ (1989) The Medical Directive. A new comprehensive advance care document. JAMA 261:3288–3293CrossRefPubMed Emanuel LL, Emanuel EJ (1989) The Medical Directive. A new comprehensive advance care document. JAMA 261:3288–3293CrossRefPubMed
10.
go back to reference McAuley WJ, Buchanan RJ, Travis SS, Wang S, Kim M (2006) Recent trends in advance directives at nursing home admission and one year after admission. Gerontologist 46:377–381PubMed McAuley WJ, Buchanan RJ, Travis SS, Wang S, Kim M (2006) Recent trends in advance directives at nursing home admission and one year after admission. Gerontologist 46:377–381PubMed
12.
go back to reference Barnard D, Quill T, Hafferty FW, Arnold R, Plumb J, Bulger R, Field M (1999) Preparing the ground: contributions of the preclinical years to medical education for care near the end of life. Working Group on the Pre-clinical Years of the National Consensus Conference on Medical Education for Care Near the End of Life. Acad Med 74:499–505CrossRefPubMed Barnard D, Quill T, Hafferty FW, Arnold R, Plumb J, Bulger R, Field M (1999) Preparing the ground: contributions of the preclinical years to medical education for care near the end of life. Working Group on the Pre-clinical Years of the National Consensus Conference on Medical Education for Care Near the End of Life. Acad Med 74:499–505CrossRefPubMed
13.
go back to reference Schonwetter RS, Robinson BE (1994) Educational objectives for medical training in the care of the terminally ill. Acad Med 69:688–690CrossRefPubMed Schonwetter RS, Robinson BE (1994) Educational objectives for medical training in the care of the terminally ill. Acad Med 69:688–690CrossRefPubMed
14.
go back to reference Sullivan AM, Lakoma MD, Billings JA, Peters AS, Block SD, Faculty PC (2005) Teaching and learning end-of-life care: evaluation of a faculty development program in palliative care. Acad Med 80:657–668CrossRefPubMed Sullivan AM, Lakoma MD, Billings JA, Peters AS, Block SD, Faculty PC (2005) Teaching and learning end-of-life care: evaluation of a faculty development program in palliative care. Acad Med 80:657–668CrossRefPubMed
15.
go back to reference Sullivan AM, Lakoma MD, Block SD (2003) The status of medical education in end-of-life care: a national report. J Gen Intern Med 18:685–695CrossRefPubMed Sullivan AM, Lakoma MD, Block SD (2003) The status of medical education in end-of-life care: a national report. J Gen Intern Med 18:685–695CrossRefPubMed
16.
go back to reference Block SD (2002) Medical education in end-of-life care: the status of reform. J Palliat Med 5:243–248CrossRefPubMed Block SD (2002) Medical education in end-of-life care: the status of reform. J Palliat Med 5:243–248CrossRefPubMed
17.
go back to reference Buss MK, Marx ES, Sulmasy DP (1998) The preparedness of students to discuss end-of-life issues with patients. Acad Med 73:418–422CrossRefPubMed Buss MK, Marx ES, Sulmasy DP (1998) The preparedness of students to discuss end-of-life issues with patients. Acad Med 73:418–422CrossRefPubMed
18.
go back to reference Green MJ, Levi BH (2009) Development of an interactive computer program for advance care planning. Health Expect 12:60–69CrossRefPubMed Green MJ, Levi BH (2009) Development of an interactive computer program for advance care planning. Health Expect 12:60–69CrossRefPubMed
19.
go back to reference Jain NL, Kahn MG (1995) Using knowledge maintenance for preference assessment. Proc Annu Symp Comput Appl Med Care 1995:263–269 Jain NL, Kahn MG (1995) Using knowledge maintenance for preference assessment. Proc Annu Symp Comput Appl Med Care 1995:263–269
20.
go back to reference Torrance GW, Boyle MH, Horwood SP (1982) Application of multi-attribute utility theory to measure social preferences for health states. Oper Res 30:1043–1069CrossRefPubMed Torrance GW, Boyle MH, Horwood SP (1982) Application of multi-attribute utility theory to measure social preferences for health states. Oper Res 30:1043–1069CrossRefPubMed
21.
go back to reference Torrance GW, Feeny DH, Furlong WJ, Barr RD, Zhang Y, Wang Q (1996) Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2. Med Care 34:702–722CrossRefPubMed Torrance GW, Feeny DH, Furlong WJ, Barr RD, Zhang Y, Wang Q (1996) Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2. Med Care 34:702–722CrossRefPubMed
22.
go back to reference Torrance GW, Furlong W, Feeny D, Boyle M (1995) Multi-attribute preference functions. Health Utilities Index. Pharmacoeconomics 7:503–520CrossRefPubMed Torrance GW, Furlong W, Feeny D, Boyle M (1995) Multi-attribute preference functions. Health Utilities Index. Pharmacoeconomics 7:503–520CrossRefPubMed
23.
go back to reference Farace E, Marupudi N, Green MJ, Levi BH, Sheehan JM (2008) The Society for NeuroOncology 13th Annual Scientific Meeting, Las Vegas, NV Farace E, Marupudi N, Green MJ, Levi BH, Sheehan JM (2008) The Society for NeuroOncology 13th Annual Scientific Meeting, Las Vegas, NV
24.
go back to reference Green MJ, Levi BH, Farace E (2007) Society for Medical Decision Making 29th Annual Meeting, Pittsburgh, PA Green MJ, Levi BH, Farace E (2007) Society for Medical Decision Making 29th Annual Meeting, Pittsburgh, PA
25.
go back to reference Green MJ, Levi BH, Farace E (2008) American Society of Preventive Oncology Annual Meeting, Bethesda, MD Green MJ, Levi BH, Farace E (2008) American Society of Preventive Oncology Annual Meeting, Bethesda, MD
26.
go back to reference Gallagher TH, Pantilat SZ, Lo B, Papadakis MA (1999) Teaching medical students to discuss advance directives: a standardized patient curriculum. Teach Learn Med 11:142–147CrossRef Gallagher TH, Pantilat SZ, Lo B, Papadakis MA (1999) Teaching medical students to discuss advance directives: a standardized patient curriculum. Teach Learn Med 11:142–147CrossRef
27.
go back to reference Lorin S, Rho L, Wisnivesky JP, Nierman DM (2006) Improving medical student intensive care unit communication skills: A novel educational initiative using standardized family members. Crit Care Med 34:2386–2391CrossRefPubMed Lorin S, Rho L, Wisnivesky JP, Nierman DM (2006) Improving medical student intensive care unit communication skills: A novel educational initiative using standardized family members. Crit Care Med 34:2386–2391CrossRefPubMed
28.
go back to reference Levi BH, Green MJ (2010) Too Soon to Give Up: Re-examining the Value of Advance Directives. Am J Bioeth 10:3–22PubMed Levi BH, Green MJ (2010) Too Soon to Give Up: Re-examining the Value of Advance Directives. Am J Bioeth 10:3–22PubMed
Metadata
Title
Teaching Advance Care Planning to Medical Students with a Computer-Based Decision Aid
Authors
Michael J. Green
Benjamin H. Levi
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
Journal of Cancer Education / Issue 1/2011
Print ISSN: 0885-8195
Electronic ISSN: 1543-0154
DOI
https://doi.org/10.1007/s13187-010-0146-2

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