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Advance Care Planning and Communication Skills Improve after an Interprofessional Team Simulation with Standardized
Leah S Millstein1,2, Paula Rosenblatt1, Melissa H Bellin3
1Department of Medicine, University of Maryland School of Medicine, University of Maryland, Baltimore, Maryland, USA.
Background:
Improving rates of advance care planning (ACP) and advance directive completion is a recognized goal of health care in the United States. No prior study has examined the efficacy of standardized patient (SP)-based student interprofessional ACP trainings.
Objectives:
The present study aims to evaluate an interprofessional approach to ACP education using SP encounters.
Design:
We designed a pre-post evaluation of an innovative interprofessional ACP training curriculum using multimodal adult learning techniques to test the effects of completing ACP discussions with SPs. Three surveys (pre-training T1, post-training T2, and post-clinical encounter T3) evaluated student knowledge, Communication Self-Efficacy (CSES), ACP self-efficacy, and interprofessional teamwork (using SPICE-R2).
Setting/Subjects:
Students from the schools of medicine, nursing, and social work attended three training modules and two SP encounters focused on ACP.
Measurements/Results:
During academic year 2018-2019, 36 students participated in the training at University of Maryland. Results demonstrated statistically significant improvements in ACP self-efficacy, M T1 = 2.9 (standard deviation [SD]T1 = 0.61) compared with M T3 = 3.9 (SDT3 = 0.51), p < 0.001, and CSES, M T1 = 4.6 (SDT1 = 1.35) versus M T3 = 7.3 (SDT3 = 0.51), p < 0.001, from T1 to T3. There was a medium-to-large improvement in knowledge from an average score of 4.3 (SD = 1.0) at T1 to an average score of 5.5 (SD = 1.4) at T2, p = 0.005, d = 0.67.
Conclusions:
Our interprofessional training module and SP encounter was successful in improving medical, social work, and nursing students' self-reported communication skills and knowledge regarding ACP.
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