PC2153: Teaching and Assessment of an Advance Care Planning Curriculum for the Med-peds Ambulatory Clinic

Purpose/Objectives: Our Med-Peds clinic is an ideal setting for advance care planning (ACP) conversations, however we discovered a variety of barriers that impede successful ACP discussions during a needs assessment survey. Most residents are somewhat comfortable having ACP discussions, but ACP discussions occur more frequently inpatient compared to outpatient. Common barriers include time restraints, discomfort, or inability to locate resources. Additionally most residents are uncomfortable navigating, updating, or documenting Advance Directives (AD) in Cerner. Most residents are interested in formal training in ACP. In light of this, we developed an initial education curriculum to supply formal training to ameliorate some of these concerns.

Design/Methods: Using a backward design approach, we developed a curriculum to delineate between code status, POLST, and ADs; to discuss legal implications; to identify appropriate mediums of ACP to use in a variety of given patient scenarios; and to explain the applicability of ACP documents as patients transition across health care settings. The educational intervention included a didactic portion and a team-based discussion utilizing real-world examples and a fillable worksheet for residents to complete during the didactic portion. The intervention was given over two separate Med-Peds Noon Conferences to capture as many of our residents as possible. Residents completed pre- and post-surveys to assess attitudes and knowledge of the material.

Results: Across all PGY classes, the post-survey yielded higher likert scores when compared to the pre-survey demonstrating improved attitudes, comfort and knowledge. The quiz did not demonstrate mastery of the topic, with a mean correct score of 67%.

Conclusion/Discussion: The implementation of our ACP educational curriculum subjectively improved resident comfort in delineating between code status, POLST, and ADs; discussing legal implications of the various types of ACP; identifying appropriate mediums of ACP to use in a variety of given patient scenarios; and explaining the applicability of ACP documents as patients transition across health care settings. Objectively, the quiz did not demonstrate mastery of the topic. However, this could have been inherent to the design of the quiz itself or a true reflection of not understanding the topic.