Development of a learning module to support treatment escalation planning and do-not-attempt cardiopulmonary resuscitation discussions

Abstract

ABSTRACT Background In response to a need for training in treatment escalation planning (TEP) and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) conversations, and in the context of the Covid-19 pandemic, an interactive on-line training module for healthcare workers was developed. Method Using four actors, three expert healthcare staff and a multi-media platform, the basic principles of TEP were introduced and explored through two semi-extempore eight-minute clinical scenarios. The videos were punctuated with prompts for leaners to record their reflections, and summaries of relevant policies or legal precedents. After each scenario, learners were invited to make comments on an anonymized public ‘notice board’. Following initial evaluation by 285 learners, changes were made to the module in response to comments made in the feedback. Results Final evaluation by 438 of 602 learners (72.5%) who engaged with the module demonstrated a very positive response (417, 95.2%) to this novel presentation of challenging concepts. Average module completion time was 31 min. Quantitative feedback via an eight-item questionnaire suggested greater confidence around theory than practice: mean score for ‘do you understand some of the key considerations and complexities in DNACPR conversations?’ was 4.17/5, compared to 3.93/5 for ‘to what extent do you feel confident to complete DNACPR conversations appropriately?’. Conclusions This brief, interactive, on-line learning module proved acceptable to healthcare staff, and led to encouraging levels of confidence in the subject through self-assessment data. It will form a foundation for work-place based staff training in TEP/DNACPR conversations.