Educational Intervention to Improve Code Status Discussion Proficiency Among Obstetrics and Gynecology Residents.

التفاصيل البيبلوغرافية
العنوان:	Educational Intervention to Improve Code Status Discussion Proficiency Among Obstetrics and Gynecology Residents.
المؤلفون:	Margolis B; 1 Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA.; 2 New York Presbyterian Hospital-Columbia University Irving Medical Center, New York, NY, USA., Blinderman C; 2 New York Presbyterian Hospital-Columbia University Irving Medical Center, New York, NY, USA.; 3 Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA., de Meritens AB; 4 Department of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA., Chatterjee-Paer S; 1 Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA.; 2 New York Presbyterian Hospital-Columbia University Irving Medical Center, New York, NY, USA., Ratan RB; 1 Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA., Prigerson HG; 5 Division of Geriatric and Palliative Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA.; 6 Center for Research on End-of-Life Care, Department of Medicine, Weill Cornell Medicine, New York, NY, USA., Hou JY; 1 Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA.; 2 New York Presbyterian Hospital-Columbia University Irving Medical Center, New York, NY, USA.; 7 Department of Gynecologic Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, New York, NY, USA., Burke WM; 1 Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA.; 2 New York Presbyterian Hospital-Columbia University Irving Medical Center, New York, NY, USA.; 8 Stony Brook University Health Sciences Center School of Medicine, Department of Gynecologic Oncology, Stony Brook, NY, USA., Wright JD; 1 Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA.; 2 New York Presbyterian Hospital-Columbia University Irving Medical Center, New York, NY, USA.; 7 Department of Gynecologic Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, New York, NY, USA., Tergas AI; 1 Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA.; 2 New York Presbyterian Hospital-Columbia University Irving Medical Center, New York, NY, USA.; 7 Department of Gynecologic Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.; 9 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
المصدر:	The American journal of hospice & palliative care [Am J Hosp Palliat Care] 2018 Apr; Vol. 35 (4), pp. 724-730. Date of Electronic Publication: 2017 Sep 26.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Sage Publications Country of Publication: United States NLM ID: 9008229 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-2715 (Electronic) Linking ISSN: 10499091 NLM ISO Abbreviation: Am J Hosp Palliat Care Subsets: MEDLINE
أسماء مطبوعة:	Publication: Thousand Oaks, Calif. : Sage Publications Original Publication: Weston, MA : Prime National Pub. Corp., c1990-
مواضيع طبية MeSH:	Resuscitation Orders, Clinical Competence/standards , Internship and Residency/organization & administration , Palliative Care/organization & administration, Adult ; Curriculum ; Female ; Gynecology/education ; Humans ; Male ; Obstetrics/education ; Physician-Patient Relations ; Pilot Projects
مستخلص:	Background: Obstetrics and gynecology (OB/GYN) residents receive little formal training in conducting code status discussions (CSDs). Objective: We piloted an educational intervention to improve resident confidence and competence at conducting CSDs. Design: The OB/GYN residents at a single institution participated in a 3-part educational program. First, participants reviewed a journal article and completed an online module. Second, they received a didactic lecture followed by a resident-to-resident mock CSD. Finally, participants had a videotaped CSD with a standardized patient (SP). Pre- and postintervention surveys and performance evaluations were analyzed. A subgroup analysis was performed on those with completed data sets. Results: Participants included 24 residents in postgraduate years (PGY) 1 to 4: 85% were female with a mean age of 29 years; 83% completed the entrance survey; 63% completed the SP CSD; and 42% completed of all parts of the intervention. Residents initially felt most prepared to discuss treatment options (3.3/5 on a Likert scale) and less prepared to discuss hospice, end-of-life care, and code status (2.2/5, 2.2/5, and 2.3/5, respectively). Performance during the resident-to-resident CSD was variable with scores (% of skills achieved) ranging from 27% to 93% (mean 64%). Performance at the SP encounter was similar with scores ranging from 40% to 73% (mean 56%). After intervention, residents felt more prepared for CSDs (3.7/5) and end-of-life care (3.9/5). The subgroup analysis failed to show a significant change in skill performance from the first to the second CSD. Conclusion: Participants found the components of this intervention helpful and reported improved confidence at conducting CSDs.
فهرسة مساهمة:	Keywords: code status discussion; education; evaluation; intervention; obstetrics and gynecology; resident
تواريخ الأحداث:	Date Created: 20170928 Date Completed: 20180910 Latest Revision: 20190610
رمز التحديث:	20221213
DOI:	10.1177/1049909117733436
PMID:	28950726
قاعدة البيانات:	MEDLINE

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الوصف
تدمد:	1938-2715
DOI:	10.1177/1049909117733436