Abstract
BackgroundPatients’ goals of care (GOC), which direct end-of-life clinical decision-making, should be established in conjunction with their primary physician when they are well. However, these discussions are often left for when critical intervention is needed in the Emergency Department, and this has been exacerbated in the new context of the current coronavirus disease 2019 pandemic. Establishing effective, formal training for Emergency Medicine (EM) residents to successfully carry out these conversations and potentially improve patient care is needed.MethodologyA physician dual-certified in Emergency Medicine and Palliative Care developed a virtual course on best practices in determining GOC for EM residents. It occurred for one hour during resident didactic conference and all residents who attended were included. A survey was sent to all participants to assess the success of the course’s content and method of delivery.ResultsOf the 39 residents who participated, 18 (46%) completed the survey. The majority (94%) agreed the course helped close knowledge gaps and increased comfort in carrying out these discussions and 100% planned to incorporate these learning points into practice. A smaller majority (61%) thought the virtual platform was an effective method of delivery and 61% felt the breakout rooms helped with learning retention. Open-ended comments reflected learners’ desire for more of this content, suggestions to augment with simulation, as well as technical difficulties experienced.ConclusionsThis course helped EM residents identify and close knowledge gaps in determining patients’ GOC who plan to incorporate what they learned into their clinical practice. Next steps in validating the course include seeking more pointed feedback of the virtual format and assessing its effects over broader audiences after making feedback-focused adjustments to its content and delivery.
Highlights
Goals of care (GOC) discussions for advanced care planning should ideally occur while a patient is well, long before end-of-life decisions are required, with their primary care physician [1]
A smaller majority (61%) thought the virtual platform was an effective method of delivery and 61% felt the breakout rooms helped with learning retention
Open-ended comments reflected learners’ desire for more of this content, suggestions to augment with simulation, as well as technical difficulties experienced. This course helped Emergency Medicine (EM) residents identify and close knowledge gaps in determining patients’ goals of care (GOC) who plan to incorporate what they learned into their clinical practice
Summary
Goals of care (GOC) discussions for advanced care planning should ideally occur while a patient is well, long before end-of-life decisions are required, with their primary care physician [1] Instead, these assessments often need to be rapidly completed in the Emergency Department (ED) when patients are acutely ill and require invasive resuscitative measures to sustain their lives [2]. Success in facilitating patient-centered care that aligns with their goals leads to an improved experience for patients and their families [4] These discussions can exacerbate anger and loss of trust if not performed correctly [5]. Establishing effective, formal training for Emergency Medicine (EM) residents to successfully carry out these conversations and potentially improve patient care is needed
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
