1. Educational Intervention to Improve Code Status Discussion Proficiency Among Obstetrics and Gynecology Residents.
- Author
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Margolis B, Blinderman C, de Meritens AB, Chatterjee-Paer S, Ratan RB, Prigerson HG, Hou JY, Burke WM, Wright JD, and Tergas AI
- Subjects
- Adult, Curriculum, Female, Gynecology education, Humans, Male, Obstetrics education, Physician-Patient Relations, Pilot Projects, Clinical Competence standards, Internship and Residency organization & administration, Palliative Care organization & administration, Resuscitation Orders
- Abstract
Background: Obstetrics and gynecology (OB/GYN) residents receive little formal training in conducting code status discussions (CSDs)., Objective: We piloted an educational intervention to improve resident confidence and competence at conducting CSDs., Design: The OB/GYN residents at a single institution participated in a 3-part educational program. First, participants reviewed a journal article and completed an online module. Second, they received a didactic lecture followed by a resident-to-resident mock CSD. Finally, participants had a videotaped CSD with a standardized patient (SP). Pre- and postintervention surveys and performance evaluations were analyzed. A subgroup analysis was performed on those with completed data sets., Results: Participants included 24 residents in postgraduate years (PGY) 1 to 4: 85% were female with a mean age of 29 years; 83% completed the entrance survey; 63% completed the SP CSD; and 42% completed of all parts of the intervention. Residents initially felt most prepared to discuss treatment options (3.3/5 on a Likert scale) and less prepared to discuss hospice, end-of-life care, and code status (2.2/5, 2.2/5, and 2.3/5, respectively). Performance during the resident-to-resident CSD was variable with scores (% of skills achieved) ranging from 27% to 93% (mean 64%). Performance at the SP encounter was similar with scores ranging from 40% to 73% (mean 56%). After intervention, residents felt more prepared for CSDs (3.7/5) and end-of-life care (3.9/5). The subgroup analysis failed to show a significant change in skill performance from the first to the second CSD., Conclusion: Participants found the components of this intervention helpful and reported improved confidence at conducting CSDs.
- Published
- 2018
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