Advance Directives

Using Visual Technology in Advance Care Planning Education

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Craig M. Klugman PhD, Jonathan Gelfond MD PhD, Kristy Kosub MD, Diane Ferguson RN BSN The University of Texas Health Science Center at San Antonio

Introduction Over the last 20 years, many publications have reported the need for training medical students in advance care planning (ACP).1-8 Challenges to an effective curriculum range from lack of physician knowledge and skill, discomfort with such conversations, and lack of practice opportunities. Several innovative programs have been tried. Torke et. al developed a half-day workshop after which students reported increased skills in breaking bad news, discussing advance directives, and managing pain.9 Gallagher et. al administered a 70-minute curriculum consisting of a short lecture followed by 2 standardized patient (SP) sessions. SPs and student selfassessments were recorded. The data suggests the program may be helpful. 10 Mueller et. al taught a 10-hour bioethics course that included advance directives. One month after the course, students self-reported feeling more knowledgeable and confident about advance care planning.11 The only control group study was conducted by Green & Levi. In a required ethics course, students were assigned to either a pen-paper packet or a computer-based tool. The results of pre/post tests show that students in the computer group learned more factual knowledge and had increased confidence.12

Results 73 SP encounters reviewed (47=intervention group, 26=control group) Statistical or correlative significance found for positive increase in

Suggestive Impacts on Video Analysis Data Label Control Intervention Total Head Nod (A >90%; B=50%; C