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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Barbara B. Blechner, MEd, JD, Deborah B. Paturzo, MS, Jonathan H. Rosen, MD, and Thomas F. Babor, PhD, MPH. Department of Community Medicine and Health Care, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-6325, (860) 679-5496, blechner@nso.uchc.edu
Routine, structured conversations about ACP in primary care offices are important components of end-of-life care for an aging population. Physicians and medical students have little formal training or experience in discussing ACP with patients, and physicians treating patients at the end-of-life are frequently unaware of patients’ wishes. Using a quasi-experimental design, two learning experiences were compared: primary care settings where medical students had no opportunity to practice ACP or observe preceptors model ACP activities (passive group n=20) and practices where students and preceptors engaged collaboratively in ACP exercises with actual patients (active group n=46). Our hypothesis was that differences would exist between the two groups. Both groups received an educational intervention consisting of lectures, ACP materials for an efficient, effective conversation, and role modeling and discussion with preceptors. Students in the active group also discussed ACP with patients in their preceptors’ offices. Results showed a significant increase in both groups’ confidence and self-efficacy about discussing ACP with patients but little change in knowledge, value of ACP discussions, or intention to discuss ACP. This research suggests that the increase in confidence was not related to the setting in which the students received their ambulatory care experience. Additionally, students and preceptors (89% and 97% of the time) perceived the project as beneficial to the office practice, found the materials useful, and found patients receptive to the discussions. Both students and preceptors strongly agreed that a main barrier to discussing ACP in the primary care office was lack of time.
Learning Objectives: At the end of the session the participants will be able to
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.