Enhancing Advance Care Planning Communication: An Interactive Workshop With Role-Play for Students and Primary Care Clinicians
Introduction Increased clinician training on advance care planning (ACP) is needed. Common barriers to ACP include perceived lack of confidence, skills, and knowledge necessary to engage in these discussions. Furthermore, many clinicians feel inadequately trained in prognostication. Evidence exists...
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| Format: | Article |
| Language: | English |
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Association of American Medical Colleges
2020-09-01
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| Series: | MedEdPORTAL |
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| Online Access: | http://www.mededportal.org/doi/10.15766/mep_2374-8265.10973 |
| _version_ | 1818994472360345600 |
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| author | Ben A. Blomberg Catherine Quintana Jingwen Hua Leslie Hargis-Fuller Jeff Laux Margaret A. Drickamer |
| author_facet | Ben A. Blomberg Catherine Quintana Jingwen Hua Leslie Hargis-Fuller Jeff Laux Margaret A. Drickamer |
| author_sort | Ben A. Blomberg |
| collection | DOAJ |
| description | Introduction Increased clinician training on advance care planning (ACP) is needed. Common barriers to ACP include perceived lack of confidence, skills, and knowledge necessary to engage in these discussions. Furthermore, many clinicians feel inadequately trained in prognostication. Evidence exists that multimodality curricula are effective in teaching ACP and can be simultaneously targeted to trainees and practicing clinicians with success. Methods We developed a 3-hour workshop incorporating lecture, patient-oriented decision aids, prognostication tools, small-group discussion, and case-based role-play to communicate a values-based approach to ACP. Cases included discussion of care goals for a patient with severe chronic obstructive pulmonary disease and one with mild cognitive impairment. The workshop was delivered to fourth-year medical students, then adapted in two primary care clinics. In the clinics, we added an interprofessional case applying ACP to management of dental pain in advanced dementia. We evaluated the workshops using pre-post surveys. Results Thirty-four medical students and 14 primary care providers participated. Self-reported knowledge and comfort regarding ACP significantly improved; attitudes toward ACP were strongly positive both before and after. The workshop was well received. On a 7-point Likert scale (1 = unacceptable, 7 = outstanding), the median overall rating was 6 (excellent). Discussion We developed an ACP workshop applicable to students and primary clinicians and saw improvements in self-reported knowledge and comfort regarding ACP. Long-term effects were not studied. Participants found the role-play especially valuable. Modifications for primary care clinics focused on duration rather than content. Future directions include expanding the workshop's content. |
| first_indexed | 2024-12-20T20:58:29Z |
| format | Article |
| id | doaj.art-0a48dbdf30ee4f3293eb9a6dd471b416 |
| institution | Directory Open Access Journal |
| issn | 2374-8265 |
| language | English |
| last_indexed | 2024-12-20T20:58:29Z |
| publishDate | 2020-09-01 |
| publisher | Association of American Medical Colleges |
| record_format | Article |
| series | MedEdPORTAL |
| spelling | doaj.art-0a48dbdf30ee4f3293eb9a6dd471b4162022-12-21T19:26:46ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652020-09-011610.15766/mep_2374-8265.10973Enhancing Advance Care Planning Communication: An Interactive Workshop With Role-Play for Students and Primary Care CliniciansBen A. Blomberg0Catherine Quintana1Jingwen Hua2Leslie Hargis-Fuller3Jeff Laux4Margaret A. Drickamer5Clinical Assistant Professor, Division of Geriatric Medicine, Department of Medicine, University of North Carolina at Chapel Hill School of MedicineCGWEP Fellow, School of Nursing, University of North Carolina at Chapel HillNurse Practitioner, Palliative Care, UNC Rex HealthcareCGWEP Fellow, Hargis Family DentistryResearch Associate, North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill School of MedicineProfessor, Division of Geriatric Medicine, Department of Medicine, University of North Carolina at Chapel Hill School of MedicineIntroduction Increased clinician training on advance care planning (ACP) is needed. Common barriers to ACP include perceived lack of confidence, skills, and knowledge necessary to engage in these discussions. Furthermore, many clinicians feel inadequately trained in prognostication. Evidence exists that multimodality curricula are effective in teaching ACP and can be simultaneously targeted to trainees and practicing clinicians with success. Methods We developed a 3-hour workshop incorporating lecture, patient-oriented decision aids, prognostication tools, small-group discussion, and case-based role-play to communicate a values-based approach to ACP. Cases included discussion of care goals for a patient with severe chronic obstructive pulmonary disease and one with mild cognitive impairment. The workshop was delivered to fourth-year medical students, then adapted in two primary care clinics. In the clinics, we added an interprofessional case applying ACP to management of dental pain in advanced dementia. We evaluated the workshops using pre-post surveys. Results Thirty-four medical students and 14 primary care providers participated. Self-reported knowledge and comfort regarding ACP significantly improved; attitudes toward ACP were strongly positive both before and after. The workshop was well received. On a 7-point Likert scale (1 = unacceptable, 7 = outstanding), the median overall rating was 6 (excellent). Discussion We developed an ACP workshop applicable to students and primary clinicians and saw improvements in self-reported knowledge and comfort regarding ACP. Long-term effects were not studied. Participants found the role-play especially valuable. Modifications for primary care clinics focused on duration rather than content. Future directions include expanding the workshop's content.http://www.mededportal.org/doi/10.15766/mep_2374-8265.10973Advance Care PlanningPrognosisRole-PlayWorkshopCommunicationCommunication Skills |
| spellingShingle | Ben A. Blomberg Catherine Quintana Jingwen Hua Leslie Hargis-Fuller Jeff Laux Margaret A. Drickamer Enhancing Advance Care Planning Communication: An Interactive Workshop With Role-Play for Students and Primary Care Clinicians MedEdPORTAL Advance Care Planning Prognosis Role-Play Workshop Communication Communication Skills |
| title | Enhancing Advance Care Planning Communication: An Interactive Workshop With Role-Play for Students and Primary Care Clinicians |
| title_full | Enhancing Advance Care Planning Communication: An Interactive Workshop With Role-Play for Students and Primary Care Clinicians |
| title_fullStr | Enhancing Advance Care Planning Communication: An Interactive Workshop With Role-Play for Students and Primary Care Clinicians |
| title_full_unstemmed | Enhancing Advance Care Planning Communication: An Interactive Workshop With Role-Play for Students and Primary Care Clinicians |
| title_short | Enhancing Advance Care Planning Communication: An Interactive Workshop With Role-Play for Students and Primary Care Clinicians |
| title_sort | enhancing advance care planning communication an interactive workshop with role play for students and primary care clinicians |
| topic | Advance Care Planning Prognosis Role-Play Workshop Communication Communication Skills |
| url | http://www.mededportal.org/doi/10.15766/mep_2374-8265.10973 |
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