Teaching medical students to discuss advance directives: A standardized patient curriculum

Background: Physicians lack skills in discussing advance directives, and me dical students receive little teaching in this area. We developed a standar dized patient curriculum to teach 3rd-year medical students to discuss adva nce directives. Purpose: The purpose of this study was to determine how frequently students perform key advance directive discussion skills, and what skills they find hard or easy. Method: This was an observational study in which 258 third-y ear medical students discussed advance directives with 2 standardized patie nts. Results: Students completed 70% of the advance directive discussion skills. A total of 62% of students asked about preferences for life-sustaining tre atment, 63% gave a numerical estimate of surviving cardiopulmonary resuscit ation (CPR), and 52% discussed outcomes of CPR. Students reported that the easiest task was eliciting the patient's choice of surrogate, and the harde st task was describing the likely outcomes of CPR. Conclusion: A standardized patient curriculum may be an effective means of teaching and assessing students' skills at discussing advance directives.