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
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
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.