A novel advance directives course provides a transformative learning experience for medical students

Paul S. Mueller, Scott C. Litin, C. Christopher Hook, Edward T. Creagan, Stephen S. Cha, Thomas J. Beckman

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: Inadequate physician training may be a barrier to physician-patient discussions of advance directives (ADs). Description: The purpose of this study was to determine the effects of an ADs course, which includes completing a directive, on medical students' perceived knowledge of and preparedness for discussing ADs with patients. All 4th-year medical students completed a 10-hr bioethics course comprising interactive lecture and small-group discussion formats. Curriculum content included ethical and legal aspects of ADs. An 8-item survey with free-text entry was administered 1 month after course completion. Internal consistency reliability of survey scores was determined. Two authors independently coded the free-text comments and reached consensus on underlying themes. Evaluation: Of the 89 students who completed the survey (response rate 80%), 87 (98%) felt more knowledgeable and 88 (99%) better equipped to counsel patients about ADs. Forty-two (47%) reported they had counseled others to complete ADs during the month after the course. Internal consistency reliability of survey scores was very good (Cronbach's α =.78). Dominant themes of responses to the question, "What was the most eye opening, troubling, or difficult aspect about filling out your advance directive?" included difficulties articulating wishes, legal language, selecting a surrogate, and facing mortality. Conclusions: These findings suggest an ADs course that includes completing a directive enhances medical students' empathy for and preparedness to discuss ADs with patients.

Original languageEnglish (US)
Pages (from-to)137-141
Number of pages5
JournalTeaching and learning in medicine
Volume22
Issue number2
DOIs
StatePublished - Apr 1 2010

ASJC Scopus subject areas

  • Education

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