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J Palliat Med. 2019 Jun;22(6):696-701. doi: 10.1089/jpm.2018.0509. Epub 2019 Jan 31.

Feasibility and Effectiveness of a Mnemonic Approach to Teach Residents How to Assess Goals of Care.

Author information

1
1 Scripps Translational Science Institute, La Jolla, California.
2
2 Scripps Health, San Diego, California.
3
3 Department of Pediatrics, UC San Diego Health, La Jolla, California.
4
4 Doris A. Howell Palliative Teams, UC San Diego Health, La Jolla, California.
5
5 UC San Diego Health Sciences, Skaggs School of Medicine, Pharmacy and Pharmaceutical Sciences, La Jolla, California.

Abstract

Background: Shared decision making is a collaborative process that allows patients, or their surrogates, and clinicians to make health care decisions together. There is an imperative to teach young physicians early in their training the importance of engaging in a shared decision-making process to define overall goals of care (GOC). The PERSON mnemonic proposes a structured format that allows providers to evaluate GOC across the spectrum of serious illnesses, outside of breaking bad news or end-of-life planning. Objectives: This study evaluated the utility of the PERSON mnemonic in training residents to have GOC with their patients, and investigated if these skills translated to the bedside with real patient encounters. Methods: First-year residents were divided into groups to participate in an in-depth education session. A pre-/postbaseline survey was administered immediately after the education intervention and approximately seven months later to assess retention and utility. Results: Thirty first-year residents were eligible for this study; 30 attended the educational sessions and completed the immediate baseline pre-/postsurvey and the seven-month follow-up survey, resulting in 100% retention rate throughout study. Residents found sustained utility in the mnemonic. It was significantly successful in increasing the knowledge and confidence level in exploring GOC. Patient-centered outcomes could not be analyzed due to low response rates and limited granularity of hospital-level data. Conclusion: The PERSON mnemonic is a feasible and useful format for teaching residents how to have a GOC discussion.

KEYWORDS:

communication; goals of care; graduate medical education; medical education; palliative; serious illness

PMID:
30702367
DOI:
10.1089/jpm.2018.0509

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