Decision-Making Capacity: A Curriculum and Evaluation Checklist for Medical Students

The objective of this study was to assess the efficacy and satisfaction of an innovative decision-making capacity curriculum in undergraduate medical education.

Authors used Kern's six-step approach for curriculum development to develop a curriculum to teach decision-making capacity assessment. Using a modified Delphi approach, authors also created a communication checklist for decision-making capacity assessment. The educational intervention was implemented for a full academic year, targeting medical students completing their core psychiatry clerkship. Changes in knowledge and comfort level were evaluated through pre- and posttests. Satisfaction was assessed using student feedback.

Of the 136 medical students who completed the core psychiatry clerkship, 64 medical students completed both a pretest and posttest. Mean knowledge scores (3.5 vs 6.1, p < 0.001) and comfort level (11% vs 89% comfortable, p < 0.001) significantly improved from pretest to posttest. One hundred and five students provided course feedback, which demonstrated positive ratings of the course.

This capacity curriculum led to significant knowledge improvement and increased self-reported comfort with capacity assessment. Health professions educators can adapt this curriculum to promote competency in this important clinical skill. Moreover, educators can use this innovative capacity communication skills checklist for both learning and evaluation.