Advance Care Planning and Communication Skills Improve after an Interprofessional Team Simulation with Standardized Patients

Abstract

Background: Improving rates of advance care planning (ACP) and advance directive completion is a recognized goal of health care in the United States. No prior study has examined the efficacy of standardized patient (SP)-based student interprofessional ACP trainings. Objectives: The present study aims to evaluate an interprofessional approach to ACP education using SP encounters. Design: We designed a pre?post evaluation of an innovative interprofessional ACP training curriculum using multimodal adult learning techniques to test the effects of completing ACP discussions with SPs. Three surveys (pre-training T1, post-training T2, and post-clinical encounter T3) evaluated student knowledge, Communication Self-Efficacy (CSES), ACP self-efficacy, and interprofessional teamwork (using SPICE-R2). Setting/Subjects: Students from the schools of medicine, nursing, and social work attended three training modules and two SP encounters focused on ACP. Measurements/Results: During academic year 2018?2019, 36 students participated in the training at University of Maryland. Results demonstrated statistically significant improvements in ACP self-efficacy, MT1?=?2.9 (standard deviation [SD]T1?=?0.61) compared with MT3?=?3.9 (SDT3?=?0.51), p?<?0.001, and CSES, MT1?=?4.6 (SDT1?=?1.35) versus MT3?=?7.3 (SDT3?=?0.51), p?<?0.001, from T1 to T3. There was a medium-to-large improvement in knowledge from an average score of 4.3 (SD?=?1.0) at T1 to an average score of 5.5 (SD?=?1.4) at T2, p?=?0.005, d?=?0.67. Conclusions: Our interprofessional training module and SP encounter was successful in improving medical, social work, and nursing students' self-reported communication skills and knowledge regarding ACP.

Keywords

• advance care planning
• graduate medical education
• interprofessional education
• standardized patients