Assessing third year medical students' understanding of code status

To assess third-year medical students' understanding of code status and its impact on patient care.

Nonrandomized, cross-sectional survey completed at the end of inpatient internal medicine clerkship rotation. The survey assessed third-year medical students' understanding, knowledge, experiences, and attitudes pertaining to code status.

Sixty-three of 94 third-year medical students completed the survey at the end of their medicine rotation in academic year 2009. More than 90% of the respondents stated that "on the job training" was their primary means of knowledge of code status and that they would like to have code status discussion as part of their medical school's curriculum. Although 100% of students knew what "code status" means, only 17% reported an "excellent" understanding. Only about 5% of students were "extremely comfortable" in facilitating a code status conversation with their patients and more than 95% felt it should be supervised. Themes emerged included the importance of role modeling and accountability for good patient care.

Third-year medical students' understanding of code status was limited to informal training during clinical care. Students perceive a lack of preparedness, which indicates an inadequacy in educating medical trainees about medical decision for resuscitation. The training for code status is greatly influenced by both resident and attending physicians, which accounts for variability in students' experiences. Further development in clinical teaching and learning about medical decision for resuscitation is needed.