Original Publication
Open Access

“Do You Want Us to Do Everything?”: Teaching Residents to Discuss Resuscitation with Hospitalized Patients

Published: June 11, 2015 | 10.15766/mep_2374-8265.10122

Included in this publication:

  • Instructor's Guide.docx
  • Discussing Resuscitation Decisions with Hospitalized Adult Patients Powerpoint.pptx
  • Appendix A Role Plays for Discussing Resuscitation Workshop.doc
  • Appendix B Competency Based Evaluation of CPR Discussions.docx
  • Appendix C Code Discussion Workshop Pre Test.docx
  • Appendix D Code Discussion Workshop Post Test.docx
  • Appendix E Code Discussion Checklist.doc

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: Internal medicine residents feel that they receive little support or precepting in end-of-life decision making. Moreover, residents infrequently address code status or provide essential information about CPR to their patients. Developed for first-year internal medicine residents, this workshop is designed to provide faculty with important tools to enhance the teaching and evaluation of communication in end-of-life decision making and to help residents overcome the barriers to addressing code status. Methods: PGY-1 residents are divided into groups of six to seven learners for each 3-hour workshop. The workshop includes an interactive presentation addressing the role of advanced care planning in the hospital setting, distinguishing actual outcomes of attempted resuscitation from commonly held misperceptions, developing a risk/benefit framework for code status discussions (CSDs), and discussing strategies for responding to patient emotions. The workshop also features a faculty demonstration of CSD (role-model role-play) and role-plays of resuscitation discussions in which the resident practices a CSD using the risk/benefit framework, participates in debriefing, and receives competency-based feedback. Results: During the 2013-2014 academic year, 26 internal medicine interns participated in the workshop, and all completed the pre- and postintervention surveys that assessed their knowledge of CPR outcomes as well as attitudes toward conducting CSDs. On the preintervention knowledge test, average percentage correct was 59%, which increased to 74% correct on the postintervention knowledge test, reflecting at least a short-term improvement in knowledge of CPR outcomes. Prior to the session, in response to the statement, “I feel motivated to facilitate resuscitation/code discussions,” the mean Likert score with a 10-point Likert scale was 8.07 (SD = 1.76); after the session, the mean intern score for the same statement was 8.58 (SD = 1.25). In contrast, prior to the session, in response to the statement, “I feel confident in facilitating code status discussions,” the mean Likert score was 6.53 (SD = 2.08); after the session, the interns’ mean score increased to 8.30 (SD = 1.30). In response to the postsession question, “How helpful did you find this workshop?” the mean score was 9.40 (SD = 1.60), reflecting a very high degree of satisfaction of participating learners. Discussion: Based on participant feedback, we have added additional education regarding prognosis to our overall curriculum, expanded the role-play scenarios, and implemented direct observation of CSDs. The use of standardized patients, who are trained to produce a scripted clinical scenario with as little variability as possible, may create a more consistent experience for all residents during the role-play simulation and debriefing.

Educational Objectives

By the end of this workshop, learners will be able to:

  1. Understand the importance of conducting code status discussions with hospitalized patients.
  2. Distinguish actual outcomes of attempted resuscitation from common misperceptions.
  3. Develop a risk/benefit framework for code status discussions.
  4. Implement patient-centered communication strategies when addressing resuscitation status in hospitalized patients.

Author Information

  • Theresa Vettese, MD: Wayne State University School of Medicine
  • Jarrett Weinberger: Wayne State University School of Medicine
  • Neelima Thati: Wayne State University School of Medicine

None to report.

None to report.

Prior Presentations
Vettese T, McNally P, Byker G. Do You Want Us to Do Everything? Teaching Residents to Discuss Resuscitation. Workshop presented at: National Meeting of the Society of General Internal Medicine; April 29, 2010; Minneapolis, Minnesota.


Vettese T, Weinberger J, Thati N. “Do you want us to do everything?”: teaching residents to discuss resuscitation with hospitalized patients. MedEdPORTAL. 2015;11:10122. https://doi.org/10.15766/mep_2374-8265.10122