Marina Knysheva

Background: At most medical institutions, there is minimal exposure to code status discussion (CSD) content before clinical education begins. Students are asked to independently perform these skills without prior instruction or guidance. Our goal was to measure medical students’ perceived benefit of code status discussion (CSD) education and determine the optimal timing for this learning. This session was developed, designed, and assessed primarily by medical students with support from palliative care faculty.

Methods: We designed a flipped classroom educational session focused on CSD that was split between an interactive lecture followed by small breakout groups discussions each led by a palliative care expert. To measure student-reported outcomes, we administered a pre- and post-survey designed to measure the benefit of the educational intervention in terms of improvement in the confidence or comfort level of students. We also surveyed medical students who had never received the intervention.

Results: After the educational intervention, more students felt prepared and comfortable with leading CSD and discussing CPR statistics. Most students who had some clinical experience reported already having had a CSD with a patient, with many having learned from a resident in FM or IM. Students who did not receive the intervention expressed that they would have preferred it to be before beginning their clinical clerkships.

Conclusion: The CSD educational intervention is valuable to the curriculum and students report desire for CSD education before clerkships. Our project is unique because it is primarily student-driven. We feel this curriculum could be well received at other institutions.