Educational Intervention to Improve Code Status Discussion Proficiency Among Obstetrics and Gynecology Residents.

Educational Intervention to Improve Code Status Discussion Proficiency Among Obstetrics and Gynecology Residents.

Publication TypeJournal Article
Year of Publication2018
AuthorsMargolis B, Blinderman C, de Meritens ABuckley, Chatterjee-Paer S, Ratan RB, Prigerson HG, Hou JY, Burke WM, Wright JD, Tergas AI
JournalAm J Hosp Palliat Care
Date Published2018 Apr

BACKGROUND: Obstetrics and gynecology (OB/GYN) residents receive little formal training in conducting code status discussions (CSDs).

OBJECTIVE: We piloted an educational intervention to improve resident confidence and competence at conducting CSDs.

DESIGN: The OB/GYN residents at a single institution participated in a 3-part educational program. First, participants reviewed a journal article and completed an online module. Second, they received a didactic lecture followed by a resident-to-resident mock CSD. Finally, participants had a videotaped CSD with a standardized patient (SP). Pre- and postintervention surveys and performance evaluations were analyzed. A subgroup analysis was performed on those with completed data sets.

RESULTS: Participants included 24 residents in postgraduate years (PGY) 1 to 4: 85% were female with a mean age of 29 years; 83% completed the entrance survey; 63% completed the SP CSD; and 42% completed of all parts of the intervention. Residents initially felt most prepared to discuss treatment options (3.3/5 on a Likert scale) and less prepared to discuss hospice, end-of-life care, and code status (2.2/5, 2.2/5, and 2.3/5, respectively). Performance during the resident-to-resident CSD was variable with scores (% of skills achieved) ranging from 27% to 93% (mean 64%). Performance at the SP encounter was similar with scores ranging from 40% to 73% (mean 56%). After intervention, residents felt more prepared for CSDs (3.7/5) and end-of-life care (3.9/5). The subgroup analysis failed to show a significant change in skill performance from the first to the second CSD.

CONCLUSION: Participants found the components of this intervention helpful and reported improved confidence at conducting CSDs.

Alternate JournalAm J Hosp Palliat Care
PubMed ID28950726

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