CL01: COMPETENCY-BASED RESIDENT TRAINING IN SURGICAL ADVANCED CARE PLANNING USING AN EMR-BASED NOTE TEMPLATE
Erin B Fennern, MD, MPH, Kathryn Chuquin, MD, Celia Divino, MD; Department of Surgery, The Mount Sinai Hospital

Background: General surgery residents report discomfort and uncertainty about their ability to address end-of-life and advanced care planning issues with patients. We aim to investigate whether the use of an EMR-based surgical goals-of-care note can improve resident skills by serving as a guide for these important patient discussions.

Methods: A surgical advanced care planning note was created to guide resident-led patient discussions regarding surgical risk, prognosis, and patient goals of care. The note was rolled out in three phases dictating which patients required a completed note. Completion of the note was monitored and ensured by the Education Office. Following completion of a note, a six question self-assessment survey was emailed to the resident author, with each question designed to assess one of the ACGME core competencies with respect to advanced care planning.

Results: Phase one and two began on November 1, 2017 and January 1, 2018. Phase three will begin March 1, 2018. Data collection is ongoing, with preliminary results expected in early April.

Conclusions: Competency-based resident education on palliative care remains lacking, despite clear evidence of a need. An EMR-based note template may aid in guiding these difficult patient conversations, which in turn may improve the resident skill set.