BackgroundDespite known advantages of advance care planning (ACP) and a positive attitude towards ACP by older people living in the community and general practitioners (GPs), such conversations are not yet commonplace in GP practices.AimTo implement ACP as part of routine care in general practice and thereby increasing the number of ACP conversations and advance directives; to investigate characteristics of older people with and without an ACP conversation.Methods(1) A pre-evaluation and post-evaluation study using questionnaire data from people aged 75 years or older living in the community. (2) A prospective study using data provided by healthcare professionals (people they started an ACP conversation with).ResultsAfter implementation of ACP, significantly more people had spoken to their GP about hospitalisations, intensive care admission and treatment preferences in certain circumstances, compared with before. Advance directives were drawn up more often. People who had an ACP conversation were older, have had a cerebrovascular accident, had a clear idea about future health problems, had a preference to start ACP before they were ill, already had an ACP conversation at pre-measurement and indicated at pre-measurement that their GP knows their preferences.ConclusionResults in number of ACP conversations and advance drectives were modest but positive. ACP was implemented as routine care. GPs select people with whom they have a conversation. This can be an efficient use of time, but there is a risk that certain groups may be underserved (for example, patients with multimorbidity or patients with less health skills).

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Our abstract is for a themed session and describes the workshop we want to give. In this workshop we will highlight the need to integrate ACP in the education of medical students and offer some examples of how to do this. Firstly, Judith Westen provides an introduction on the training needs of medical students and the current place of palliative care and ACP in the Dutch medical curricula. Then, Roeline Pasman discusses the outline of a minor on palliative care. She will illustrate the basic ingredients of the minor and show how ACP is integrated in the minor. Thirdly, in small groups, the participants of the workshop will experience different work forms that can be used to stimulate awareness of the need for ACP and train patientphysician communication regarding ACP (e.g discussion of a movie, role play, discussion on different communication styles). Afterwards the participants discuss their experiences and share ideas on how to integrate ACP in local training and education.

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