Medical students' experiences using an online decision aid to engage in advance care planning

Abstract

Most physicians report that their medical training inadequately prepared them to help patients engage in advance care planning (ACP). This study examined the experience of medical students who used an online decision aid as a tool for assisting individuals through the process of ACP and creating a personalised advance directive. As part of a required unit on “doctoring,” third-year medical students at a single institution helped another adult complete an advance directive using an online decision aid for ACP. They then wrote an essay describing their experience with this exercise. Investigators coded 64 student essays and identified four common themes: 1) Challenges for students completing this exercise; 2) Challenges for the individuals engaging in ACP; 3) Recommendations for implementing ACP in practice; and 4) Feedback on the decision aid. Most students reported the exercise to be valuable, and many reported having learned a great deal about not only the complexity of ACP, but also the challenges of accurately predicting as well as documenting and interpreting another person's values and wishes. Students provided several recommendations for improving the online decision aid, but were generally very pleased with its ease of use, helpfulness in explaining complex ACP issues, and accuracy in helping articulate and document an individual's wishes for future medical care. This study suggests that an online decision aid can help prepare physicians in training to engage in ACP with patients.