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Medical Student Training on Code Status Discussions: How Far Have We Come?
Lynnea M Mills1, Caroline Rhoads2, J Randall Curtis3
11 Department of Medicine, Division of Hospital Medicine, University of California , San Francisco, San Francisco, California.
Journal of Palliative Medicine
|November 21, 2015
Summary
Graduating medical students report insufficient training in code status discussions, despite the importance of patient communication. Most students feel underprepared for these critical end-of-life conversations at residency
Area of Science:
- Medical Education
- Patient-Provider Communication
- End-of-Life Care Discussions
Background:
- Growing emphasis on patient-centered care and education.
- Code status discussions are a key component of patient-provider communication.
Purpose of the Study:
- Assess undergraduate medical education (UME) on communication skills.
- Evaluate graduating students' exposure to and comfort with code status discussions.
Main Methods:
- Survey of fourth-year medical students matched to internal medicine residency.
- Assessed experiences, self-confidence, and need for further education on code status discussions.
Main Results:
- 56 students from 32 medical schools surveyed (89% response rate).
- Varied experience observing/conducting discussions; infrequent guidance received.
- Students reported moderate self-confidence but desired supervision and formal instruction.
Conclusions:
- Medical students often feel underprepared for code status discussions.
- Despite focus on communication, UME may not adequately equip students for end-of-life care conversations.
- Further formal instruction is requested by students entering residency.
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