Advance directives as a topic in medical education

Bastos, Thalita da Rocha; Macedo, Letícia Fonseca; Silva, Yasmim Carmine Brito da; Braga, Thaisy Luane Gomes Pereira; Salgado, Renan Soeiro; Soeiro, Ana Cristina Vidigal

doi:10.1590/1983-803420243696EN

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RESEARCH • Rev. Bioét. 32 • 2024 • https://doi.org/10.1590/1983-803420243696EN copy

Advance directives as a topic in medical education

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study investigated the knowledge of medical professors and students during internship regarding advance directives, a device that aims to ensure the right of patients to record their preference for medical care they will be subject to when incapable of making decisions. This is a cross-sectional, descriptive and observational study with a mostly quantitative approach, of which participated 30 professors and 121 medical students from two teaching institutions in Belém/PA. The results identified gaps in the knowledge about the topic, pointing to the need for a deeper approach during medical training and practice. It is concluded that the divulging of advance directives in medical training should be more intense to favor autonomy and share decision making.

Keywords
Advance directives; Terminal care; Education, medical; Knowledge; Bioethics

Variable	No	Unable to answer	Yes	p value
Can you define AD?				0.080
Professor (n=30)	12 (40%)	3 (10%)	15 (50%)
Student (n=121)	63 (52.1%)	23 (19%)	35 (28.9%)
Do you know any CFM resolution on AD?				0.275
Professor (n=30)	16 (53.3%)	6 (20%)	8 (26.7%)
Student (n=121)	83 (68.6%)	18 (14.9%)	20 (16.5%)
Can you define living will?				<0.001
Professor (n=30)	14 (46.7%)*	2 (6.6%)	14 (46.7%)†
Student (n=121)	84 (69.4%)†	24 (19.8%)	13 (10.8%)*
Do you believe that AD and living will are the same thing?				0.023
Professor (n=30)	11 (36.7%)	13 (43.3%)	6 (20.0%)†
Student (n=121)	58 (47.9%)	57 (47.1%)	6 (5.0%)*
Do you know the meaning of “healthcare power of attorney” or “durable power of attorney”?				0.039
Professor (n=30)	13 (43.3%)*	7 (23.3%)	10 (33.3%)†
Student (n=121)	81 (66.9%)†	21 (17.4%)	19 (15.7%)*
Do you know any CFM resolution on “refusal of treatment”?				0.129
Professor (n=30)	10 (33.3%)	3 (10%)	17 (56.7%)
Student (n=121)	64 (52.9%)	12 (9.9%)	45 (37.2%)
Have you heard of advance directives for cardiopulmonary resuscitation?				0.377
Professor (n=30)	9 (30%)	3 (10%)	18 (60%)
Student (n=121)	26 (21.5%)	7 (5.8%)	88 (72.7%)

Variable	No	Unable to answer	Yes	p value
Can you define AD?				0.002
Private (n=51)	25 (49%)	4 (7.8%)*	22 (43.1%)†
Public (n=70)	38 (54.3%)	19 (27.1%)†	13 (18.6%)*
Do you know any CFM resolution on AD?				<0.001
Private (n=51)	31 (60.8%)	4 (7.8%)	16 (31.4%)†
Public (n=70)	52 (74.3%)	14 (20%)	4 (5.7%)*
Can you define living will?				0.159
Private (n=51)	36 (70.6%)	7 (13.7%)	8 (15.7%)
Public (n=70)	48 (68.6%)	17 (24.3%)	5 (7.1%)
Do you believe that AD and living will are the same thing?				0.407
Private (n=51)	25 (49%)	22 (43.1%)	4 (7.8%)
Public (n=70)	33 (47.1%)	35 (50%)	2 (2.9%)
Do you know the meaning of “healthcare power of attorney” or “durable power of attorney”?				0.368
Private (n=51)	37 (72.5%)	6 (11.8%)	8 (15.7%)
Public (n=70)	44 (62.9%)	15 (21.4%)	11 (15.7%)
Do you know any CFM resolution on “refusal of treatment”?				0.499
Private (n=51)	30 (58.8%)	5 (9.8%)	16 (31.4%)
Public (n=70)	34 (48.6%)	7 (10%)	29 (41.4%)
Have you heard of advance directives for cardiopulmonary resuscitation?				0.753
Private (n=51)	11 (21.6%)	2 (3.9%)	38 (74.5%)
Public (n=70)	15 (21.4%)	5 (7.1%)	50 (71.4%)

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[1] Correspondence Thalita da Rocha Bastos – Passagem São Pedro, 43, Atalaia CEP 67013-710. Ananindeua/PA, Brasil.