Physicians' confidence in discussing do not resuscitate orders with patients and surrogates

Purpose: Physicians are often reluctant to discuss 'Do Not Resuscitate' (DNR) orders with patients. Although perceived self-efficacy (confidence) is a known prerequisite for behavioural change, little is understood about the confidence of physicians regarding DNR discussions. Subjects and methods: A survey of 217 internal medicine attendings and 132 housestaff at two teaching hospitals about their attitudes and confidence regarding DNR discussions. Results: Participants were significantly less confident about their ability to discuss DNR orders than to discuss consent for medical procedures (p Conclusion: We conclude that physicians' confidence regarding DNR discussions is low compared with their confidence regarding other medical discussions and that confidence varies by sex and perceived difficulty of the task. Efforts to improve DNR discussions should explore the need to tailor educational interventions to fit these characteristics.