Code Status Discussions: A Standardized Patient Workshop for Senior Medical Students

Residents frequently conduct code status discussions (CSDs) with patients, but many report not receiving formal training in this skill. While institutions have attempted to address this, there remains a need for a curriculum that uses standardized patients (SPs), is generalizable to students interested in different medical specialties, and has been tested on a large sample of students.

We trained 192 fourth-year medical students across four different campuses in how to conduct CSDs during one 2-hour workshop as part of their Transition to Residency course in April 2024. Students worked with SPs as part of this workshop. Students at our main campus completed pre- and postworkshop paper surveys evaluating their confidence levels across five domains.

A total of 84 (69%) of the 121 students at the main campus completed both a pre- and postworkshop survey. There was a statistically significant change in confidence levels from pre- to postworkshop, with a higher proportion of students selecting increased confidence levels across all five questions on the postworkshop survey.

Our workshop increased the confidence of fourth-year medical students in conducting CSDs. This session successfully implemented simulations that used SPs for training a large group of fourth-year medical students bound for different medical specialties. This is the first workshop of its size and breadth, and it may serve as a standardized curriculum for other institutions wishing to formally train medical students to conduct CSDs.