Code status discussion skill retention in internal medicine residents

One-year follow-up

Diane Bronstein Wayne*, Farzad Moazed, Elaine R. Cohen, Rashmi K. Sharma, William Craig McGaghie, Eytan Szmuilowicz

*Corresponding author for this work

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Communicating with patients about goals of care is an important skill for internal medicine residents. However, many trainees are not competent to perform a code status discussion (CSD). A multimodality intervention improved skills in a group of first-year residents in 2011. How long these acquired CSD skills are retained is unknown. Objective: To study CSD skill retention one year after a multimodality intervention. Design: This was a longitudinal cohort study. Setting/Subjects: Thirty-eight second-year internal medicine residents in a university-affiliated internal medicine residency program participated in the study. Nineteen completed the intervention and 19 served as controls. Measurements: Mean CSD clinical skills examination (CSE) scores using an 18-item checklist were compared after the intervention (2011) and one year later (2012). Results: Intervention group residents performed significantly better than residents in the control group (71.9% (standard deviation [SD]=16.0%) versus 54.7% (SD=17.1%; p<0.001) at one-year follow-up. Intervention group residents retained their CSD skills at one year as performance was 75.1% in 2011 and 71.9% in 2012 (p=0.46). Control group residents did not develop additional CSD skills as 2011 checklist performance was 53.2% and 2012 performance was 54.7% (p=0.78). Conclusions: CSD skills taught in a rigorous curriculum are retained at one-year follow-up. Residents in the control group did not acquire new CSD skills despite an additional year of training and clinical experience. Further study is needed to link improved CSD skills to better patient care quality.

Original languageEnglish (US)
Pages (from-to)1325-1328
Number of pages4
JournalJournal of palliative medicine
Volume15
Issue number12
DOIs
StatePublished - Dec 1 2012

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Internal Medicine
Checklist
Control Groups
Patient Care Planning
Clinical Competence
Internship and Residency
Curriculum
Longitudinal Studies
Patient Care
Cohort Studies

ASJC Scopus subject areas

  • Nursing(all)
  • Anesthesiology and Pain Medicine

Cite this

@article{314221e1eae24733b211386ad4fdee99,
title = "Code status discussion skill retention in internal medicine residents: One-year follow-up",
abstract = "Background: Communicating with patients about goals of care is an important skill for internal medicine residents. However, many trainees are not competent to perform a code status discussion (CSD). A multimodality intervention improved skills in a group of first-year residents in 2011. How long these acquired CSD skills are retained is unknown. Objective: To study CSD skill retention one year after a multimodality intervention. Design: This was a longitudinal cohort study. Setting/Subjects: Thirty-eight second-year internal medicine residents in a university-affiliated internal medicine residency program participated in the study. Nineteen completed the intervention and 19 served as controls. Measurements: Mean CSD clinical skills examination (CSE) scores using an 18-item checklist were compared after the intervention (2011) and one year later (2012). Results: Intervention group residents performed significantly better than residents in the control group (71.9{\%} (standard deviation [SD]=16.0{\%}) versus 54.7{\%} (SD=17.1{\%}; p<0.001) at one-year follow-up. Intervention group residents retained their CSD skills at one year as performance was 75.1{\%} in 2011 and 71.9{\%} in 2012 (p=0.46). Control group residents did not develop additional CSD skills as 2011 checklist performance was 53.2{\%} and 2012 performance was 54.7{\%} (p=0.78). Conclusions: CSD skills taught in a rigorous curriculum are retained at one-year follow-up. Residents in the control group did not acquire new CSD skills despite an additional year of training and clinical experience. Further study is needed to link improved CSD skills to better patient care quality.",
author = "Wayne, {Diane Bronstein} and Farzad Moazed and Cohen, {Elaine R.} and Sharma, {Rashmi K.} and McGaghie, {William Craig} and Eytan Szmuilowicz",
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Code status discussion skill retention in internal medicine residents : One-year follow-up. / Wayne, Diane Bronstein; Moazed, Farzad; Cohen, Elaine R.; Sharma, Rashmi K.; McGaghie, William Craig; Szmuilowicz, Eytan.

In: Journal of palliative medicine, Vol. 15, No. 12, 01.12.2012, p. 1325-1328.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Code status discussion skill retention in internal medicine residents

T2 - One-year follow-up

AU - Wayne, Diane Bronstein

AU - Moazed, Farzad

AU - Cohen, Elaine R.

AU - Sharma, Rashmi K.

AU - McGaghie, William Craig

AU - Szmuilowicz, Eytan

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Background: Communicating with patients about goals of care is an important skill for internal medicine residents. However, many trainees are not competent to perform a code status discussion (CSD). A multimodality intervention improved skills in a group of first-year residents in 2011. How long these acquired CSD skills are retained is unknown. Objective: To study CSD skill retention one year after a multimodality intervention. Design: This was a longitudinal cohort study. Setting/Subjects: Thirty-eight second-year internal medicine residents in a university-affiliated internal medicine residency program participated in the study. Nineteen completed the intervention and 19 served as controls. Measurements: Mean CSD clinical skills examination (CSE) scores using an 18-item checklist were compared after the intervention (2011) and one year later (2012). Results: Intervention group residents performed significantly better than residents in the control group (71.9% (standard deviation [SD]=16.0%) versus 54.7% (SD=17.1%; p<0.001) at one-year follow-up. Intervention group residents retained their CSD skills at one year as performance was 75.1% in 2011 and 71.9% in 2012 (p=0.46). Control group residents did not develop additional CSD skills as 2011 checklist performance was 53.2% and 2012 performance was 54.7% (p=0.78). Conclusions: CSD skills taught in a rigorous curriculum are retained at one-year follow-up. Residents in the control group did not acquire new CSD skills despite an additional year of training and clinical experience. Further study is needed to link improved CSD skills to better patient care quality.

AB - Background: Communicating with patients about goals of care is an important skill for internal medicine residents. However, many trainees are not competent to perform a code status discussion (CSD). A multimodality intervention improved skills in a group of first-year residents in 2011. How long these acquired CSD skills are retained is unknown. Objective: To study CSD skill retention one year after a multimodality intervention. Design: This was a longitudinal cohort study. Setting/Subjects: Thirty-eight second-year internal medicine residents in a university-affiliated internal medicine residency program participated in the study. Nineteen completed the intervention and 19 served as controls. Measurements: Mean CSD clinical skills examination (CSE) scores using an 18-item checklist were compared after the intervention (2011) and one year later (2012). Results: Intervention group residents performed significantly better than residents in the control group (71.9% (standard deviation [SD]=16.0%) versus 54.7% (SD=17.1%; p<0.001) at one-year follow-up. Intervention group residents retained their CSD skills at one year as performance was 75.1% in 2011 and 71.9% in 2012 (p=0.46). Control group residents did not develop additional CSD skills as 2011 checklist performance was 53.2% and 2012 performance was 54.7% (p=0.78). Conclusions: CSD skills taught in a rigorous curriculum are retained at one-year follow-up. Residents in the control group did not acquire new CSD skills despite an additional year of training and clinical experience. Further study is needed to link improved CSD skills to better patient care quality.

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