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To Code or Not To Code: Teaching Multidisciplinary Clinicians to Conduct Code Status Discussions.

Brigit C Palathra1, Fernando Kawai1, Clara Oromendia2

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|January 8, 2019
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Summary
This summary is machine-generated.

An educational intervention significantly improved clinician knowledge and communication skills for code status discussions (CSDs). Most participants reported learning new information and intending to change patient management strategies.

Keywords:
advance directivescode status discussioncommunication trainingmultidisciplinary

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Area of Science:

  • Medical Education
  • Clinical Communication
  • Palliative Care

Background:

  • Code status discussions (CSDs) present challenges for clinicians due to limited education, comfort, and experience.
  • Effective communication in CSDs is crucial for patient-centered care and aligning medical interventions with patient values.

Purpose of the Study:

  • To implement and evaluate an educational intervention aimed at enhancing clinician knowledge and communication skills related to CSDs.
  • To assess the impact of a multidisciplinary educational program on healthcare professionals' confidence and approach to CSDs.

Main Methods:

  • A cross-sectional, one-year multidisciplinary educational intervention involving interactive presentations and live role-playing.
  • Pre- and post-intervention tests were administered to 165 participants (physicians, nurses, residents, fellows, PAs) to measure knowledge and communication approach.
  • Qualitative evaluations and participant comments were collected to assess program impact and perceived changes in practice.

Main Results:

  • Significant improvement in overall test scores from 43.8% pre-intervention to 75.6% post-intervention (p<0.005).
  • Nurses and physician assistants (PAs) showed the lowest pre-intervention scores, while attending physicians and fellows had the highest.
  • 97% of participants reported learning new information, and 91% indicated they would alter patient management based on the training.

Conclusions:

  • A brief, multipronged educational intervention effectively improved clinician knowledge and confidence in conducting CSDs.
  • The study highlights the need for targeted CSD training across various healthcare disciplines to enhance patient care.
  • Future research should explore the correlation between educational interventions, clinician knowledge, and actual clinical practice outcomes in CSDs.