title: Enhancing competency in professionalism: targeting resident advance directive education.
abstract: BACKGROUND
  Education about advance directives typically is incorporated into medical school curricula and is not commonly offered in residency. Residents' experiences with advance directives are generally random, nonstandardized, and difficult to assess. In 2008, an advance directive curriculum was developed by the Scott & White/Texas A&M University System Health Science Center College of Medicine (S&W/Texas A&M) internal medicine residency program and the hospital's legal department. A pilot study examining residents' attitudes and experiences regarding advance directives was carried out at 2 medical schools.
  
  
  METHODS
  In 2009, 59 internal medicine and family medicine residents (postgraduate year 2-3 [PGY-2, 3]) completed questionnaires at S&W/Texas A&M (n  =  32) and The University of Texas Medical School at Houston (n  =  27) during a validation study of knowledge about advance directives. The questionnaire contained Likert-response items assessing attitudes and practices surrounding advance directives. Our analysis included descriptive statistics and analysis of variance (ANOVA) to compare responses across categories.
  
  
  RESULTS
  While 53% of residents agreed/strongly agreed they had "sufficient knowledge of advance directives, given my years of training," 47% disagreed/strongly disagreed with that statement. Most (93%) agreed/strongly agreed that "didactic sessions on advance directives should be offered by my hospital, residency program, or medical school." A test of responses across residency years with ANOVA showed a significant difference between ratings by PGY-2 and PGY-3 residents on 3 items: "Advance directives should only be discussed with patients over 60," "I have sufficient knowledge of advance directives, given my years of training," and "I believe my experience with advance directives is adequate for the situations I routinely encounter."
  
  
  CONCLUSIONS
  Our study highlighted the continuing need for advance directive resident curricula. Medical school curricula alone do not appear to be sufficient for residents' needs in this area.
authors: Colleen Y
authors: CY
authors: Colbert
authors: Curtis
authors: C
authors: Mirkes
authors: Paul E
authors: PE
authors: Ogden
authors: Mary Elizabeth
authors: ME
authors: Herring
authors: Christian
authors: C
authors: Cable
authors: John D
authors: JD
authors: Myers
authors: Allison R
authors: AR
authors: Ownby
authors: Eugene
authors: E
authors: Boisaubin
authors: Ida
authors: I
authors: Murguia
authors: Mark A
authors: MA
authors: Farnie
authors: Mark
authors: M
authors: Sadoski