Teaching general practitioners and doctors-in-training to discuss advance care planning: evaluation of a brief multimodality education programme

Objective

To develop and evaluate an interactive advance care planning (ACP) educational programme for general practitioners and doctors-in-training.

Design

Development of training materials was overseen by a committee; informed by literature and previous teaching experience. The evaluation assessed participant confidence, knowledge and attitude toward ACP before and after training.

Setting

Training provided to metropolitan and rural settings in Victoria, Australia.

Participants

148 doctors participated in training. The majority were aged at least 40 years with more than 10 years work experience; 63% had not trained in Australia.

Intervention

The programme included prereading, a DVD, interactive patient e-simulation workshop and a training manual. All educational materials followed an evidence-based stepwise approach to ACP: Introducing the topic, exploring concepts, introducing solutions and summarising the conversation.

Main outcome measures

The primary outcome was the change in doctors’ self-reported confidence to undertake ACP conversations. Secondary measures included pretest/post-test scores in patient ACP e-simulation, change in ACP knowledge and attitude, and satisfaction with programme materials.

Results

69 participants completed the preworkshop and postworkshop evaluation. Following education, there was a significant change in self-reported confidence in six of eight items (p=0.008 –0.08). There was a significant improvement (p<0.001) in median scores on the e-simulation (pre 7/80, post 60/80). There were no significant differences observed in ACP knowledge following training, and most participants were supportive of patient autonomy and ACP pretraining. Educational materials were rated highly.

Conclusions

A short multimodal interactive education programme improves doctors’ confidence with ACP and performance on an ACP patient e-simulation.