Discussing Life-Sustaining Treatment: A Teaching Program for Residents

Geoffrey H. Gordon, Susan W. Tolle

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Ideally, physicians and patients should discuss patient preferences for life-sustaining treatment before the onset of cognitive impairment or a life-threatening illness; however, these conversations often do not occur. We developed an educational program in which residents practiced discussing advance directives with volunteer simulated outpatients and then received feedback from the patient, an observing resident, and a faculty member. Residents found the training sessions to be realistic, relevant, and useful. Resident self-ratings improved significantly on eight items representing knowledge, skills, and attitudes about discussing advance directives with patients. Resident learning occurred in four major areas: technical knowledge about advance directives; introducing the topic to patients; giving patients information; and eliciting patients’ values and feelings. We conclude that residents need and want training in this area and that simulated patients act as a catalyst for their learning.

Original languageEnglish (US)
Pages (from-to)567-570
Number of pages4
JournalArchives of internal medicine
Issue number3
StatePublished - Mar 1991

ASJC Scopus subject areas

  • Internal Medicine


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