Skip to main content
Erschienen in: Journal of Cancer Education 1/2011

01.03.2011

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

verfasst von: Michael J. Green, Benjamin H. Levi

Erschienen in: Journal of Cancer Education | Ausgabe 1/2011

Einloggen, um Zugang zu erhalten

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.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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
11.
12.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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
Metadaten
Titel
Teaching Advance Care Planning to Medical Students with a Computer-Based Decision Aid
verfasst von
Michael J. Green
Benjamin H. Levi
Publikationsdatum
01.03.2011
Verlag
Springer-Verlag
Erschienen in
Journal of Cancer Education / Ausgabe 1/2011
Print ISSN: 0885-8195
Elektronische ISSN: 1543-0154
DOI
https://doi.org/10.1007/s13187-010-0146-2

Weitere Artikel der Ausgabe 1/2011

Journal of Cancer Education 1/2011 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.