Enhancing competency in professionalism: targeting resident advance directive education

Area of Science:

• Medical Education
• Bioethics
• Patient Care

Background:

• Advance directive education is typically limited to medical school, not residency programs.
• Residents' experiences with advance directives are often unstructured and difficult to evaluate.
• A specific advance directive curriculum was developed in 2008 for an internal medicine residency program.

Purpose of the Study:

• To assess internal medicine and family medicine residents' attitudes and knowledge regarding advance directives.
• To evaluate the adequacy of current training in advance directives for residents.
• To identify specific areas where residents feel their knowledge and experience are lacking.

Main Methods:

• A questionnaire assessing attitudes and practices related to advance directives was administered to 59 residents (PGY-2, 3).
• Participants were from two medical schools: Scott & White/Texas A&M and The University of Texas Medical School at Houston.
• Descriptive statistics and ANOVA were used to analyze the data, comparing responses across residency years.

Main Results:

• Only 53% of residents felt they had sufficient knowledge of advance directives.
• A significant majority (93%) agreed that didactic sessions on advance directives should be provided.
• PGY-2 and PGY-3 residents differed significantly in their views on when advance directives should be discussed and their perceived adequacy of training.

Conclusions:

• The study underscores a persistent need for comprehensive advance directive curricula within residency programs.
• Existing medical school education is insufficient to meet residents' needs for advance directive competency.
• Further development and implementation of structured residency training in advance directives are recommended.