| Summary: | Abstract This tool was created to address a perceived gap in the education of our postgraduate internal medicine trainees around the practical aspects of end-of-life decision making. Based on an extensive up-to-date literature review of the topic, the PowerPoint presentation outlines several facets of end-of-life decision making: (1) components of these decisions and generally accepted definitions, (2) factors affecting patients' decisions, (3) substitute decision-maker accuracy, (4) physician-level factors affecting decision making, and (5) implications for everyday practice. The presentation is intended to be a springboard for an interactive discussion of experiences with end-of-life decisions and is best suited to an audience that has some experience with these situations (e.g., medical or surgical residents, ICU fellows, etc.). The session is 2 hours in duration, with a 10-minute break in the middle. It is possible to reduce the session to just 1 hour, but this will potentially curtail some of the discussion, which is likely to be the most stimulating and highest-rated component of the session. This session is unique in that it provides a forum for discussion, as well as an overview of the current state of the art in the factors known to influence end-of-life decision making. It has been presented as a 1-hour round for medical residents and students in two Toronto teaching hospitals. Although not formally evaluated, it was anecdotally highly rated by trainees at all levels.
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