Abstract
Background: Physicians lack skills in discussing advance directives, and medical students receive little teaching in this area. We developed a standardized patient curriculum to teach 3rd-year medical students to discuss advance directives. Purpose: The purpose of this study was to determine how frequently students perform key advance directive discussion skills, and what skills they find hard or easy. Method: This was an observational study in which 258 third-year medical students discussed advance directives with 2 standardized patients. Results: Students completed 70% of the advance directive discussion skills. A total of 62% of students asked about preferences for life-sustaining treatment, 63% gave a numerical estimate of surviving cardiopulmonary resuscitation (CPR), and 52% discussed outcomes of CPR. Students reported that the easiest task was eliciting the patient's choice of surrogate, and the hardest task was describing the likely outcomes of CPR. Conclusion: A standardized patient curriculum may be an effective means of teaching and assessing students' skills at discussing advance directives.
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