| 1. Problem identification and general needs assessment |
Research describing the best methods for training residents in this area is generally lacking. Based upon results of few studies, CSD training for medical residents is well received and has the potential to improve confidence and performance. |
| 2. Targeted needs assessment |
No formal training programs for CSD/GOCD have ever been published for anesthesiology trainees. Managing a patient's DNR status in the perioperative period is a specific example scenario listed in the OSCE content outline put forth by the ABA. |
| 3. Goals and objectives |
Residents will verbalize strategies for completing a successful and effective CSD/GOCD. Residents will demonstrate the following skills when performing a CSD/GOCD: (1) engage in patient-centered interviewing skills, (2) address patient-specific values and goals of care, (3) explain informed consent for code status with an emphasis on clarifying DNR status, and (4) respond to emotion. |
| 4. Educational strategies |
Selected journal articles describing CSD/GOCD skills and communication strategies Formal, online learning modules OSCE experiences prior to and after completing the educational content |
| 5. Implementation |
Precurriculum OSCE to assess baseline knowledge and skills Residents will have approximately 2 weeks to review the educational content at their own pace Postcurriculum OSCE will include feedback from the rater and standardized patient |
| 6. Evaluating the effectiveness of the curriculum |
Evaluation of the immediate effect on improving CSD/GOCD skills will occur with a postcurriculum OSCE performance assessment Survey distribution at 3 and 6 months will evaluate interim experiences and internalization of the CSD/GOCD training |
