Evaluating an Advance Care Planning Curriculum: a Lecture, a Game, a Patient, and an Essay

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Abstract

Purpose: Curricula on advance care planning are commonly absent or inadequate in the majority of medical schools. This study assessed an advance care planning mini-curriculum involving a lecture, an end-of-life conversation game, a patient encounter during which students facilitated completion of an advance directive, and a subsequent reflective essay. Methods: This convergent, mixed methods study used a pre-post, longitudinal design. Confidence having end-of-life conversations was assessed at three timepoints. A linear mixed effects model compared mean confidence at the three timepoints. Focus groups and open-ended questionnaires (analyzed using content analysis) explored student perceptions of the curricula. Results: Sixty-nine of 149 students completed the questionnaires; 18 students participated in the focus groups. Confidence scores increased by 10.3 points (+ 4.2 post-lecture/game; + 6.1 post-patient assignment/essay; p < 0.001 for all timepoints). Students felt the game (1) was a good “starting point” for learning to initiate end-of-life conversations; (2) fostered internal and external reflections about advance care planning; and (3) allowed exploration of the complexities of end-of-life discussions. Qualitative exploration suggested that high-level learning—interpreted through the lens of Bloom’s taxonomy—occurred. Conclusion: Mixed methods data suggest that the advance care planning mini-curriculum effectively increased student confidence having end-of-life conversations. Qualitative analyses revealed student learning covering all of tiers of Bloom’s taxonomy.

Original languageEnglish (US)
Pages (from-to)453-462
Number of pages10
JournalMedical Science Educator
Volume29
Issue number2
DOIs
StatePublished - Jun 15 2019

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Advance Care Planning
curriculum planning
Curriculum
Students
conversation
confidence
student
Focus Groups
Learning
Advance Directives
curriculum
planning
questionnaire
Medical Schools
taxonomy
Lenses
learning
content analysis
Group

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Education

Cite this

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title = "Evaluating an Advance Care Planning Curriculum: a Lecture, a Game, a Patient, and an Essay",
abstract = "Purpose: Curricula on advance care planning are commonly absent or inadequate in the majority of medical schools. This study assessed an advance care planning mini-curriculum involving a lecture, an end-of-life conversation game, a patient encounter during which students facilitated completion of an advance directive, and a subsequent reflective essay. Methods: This convergent, mixed methods study used a pre-post, longitudinal design. Confidence having end-of-life conversations was assessed at three timepoints. A linear mixed effects model compared mean confidence at the three timepoints. Focus groups and open-ended questionnaires (analyzed using content analysis) explored student perceptions of the curricula. Results: Sixty-nine of 149 students completed the questionnaires; 18 students participated in the focus groups. Confidence scores increased by 10.3 points (+ 4.2 post-lecture/game; + 6.1 post-patient assignment/essay; p < 0.001 for all timepoints). Students felt the game (1) was a good “starting point” for learning to initiate end-of-life conversations; (2) fostered internal and external reflections about advance care planning; and (3) allowed exploration of the complexities of end-of-life discussions. Qualitative exploration suggested that high-level learning—interpreted through the lens of Bloom’s taxonomy—occurred. Conclusion: Mixed methods data suggest that the advance care planning mini-curriculum effectively increased student confidence having end-of-life conversations. Qualitative analyses revealed student learning covering all of tiers of Bloom’s taxonomy.",
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