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PP19.006 From medical and nursing students to head physicians and advanced practice nurses: advance care planning communication skills training in Switzerland
  1. Ulrike Elisabeth Ehlers1,2,
  2. Tanja Krones2,
  3. Isabelle Karzig2,
  4. Barbara Loupatatzis2,3,
  5. Esther Liem2 and
  6. Settimio Monteverde2,4
  1. 1Surgical Intensive Care Unit, Cantonal Hospital, St. Gallen, Switzerland
  2. 2Clinical Ethics Unit, University Hospital of Zurich and University of Zurich, Institute of Biomedical Ethics and History of Medicine, Zurich, Switzerland
  3. 3Palliative Care, Hospital Wetzikon, Wetzikon, Switzerland
  4. 4University of Applied Sciences, School of Health Professions, Bern, Switzerland


Background Conversations about treatment goals, care planning and shared decision making are key to patient-centered care and rely heavily on specific communication skills. In Switzerland, Advance Care Planning (ACP) and shared decision making have been integrated into the curricula of many medical, nursing, and other health care professions and is increasingly addressed in postgraduate education. In Switzerland, there is yet no overarching concept for teaching communication skills regarding ACP.

Methods Based on the existing curriculum, we describe the development of ACP education in Switzerland from basic to postgraduate teaching and clinical training. The specific contribution of different disciplines, including teaching (e.g., serious moral games, simulated patients), domain-specific knowledge (e.g., critical care), and communication skills, is presented, as well as approaches to assessing learners’ knowledge and skills through Objective Structured Clinical Examination (OSCE) and other feedback tools.

Results Based on our findings, we develop a generic concept for teaching ACP to students, ACP facilitators, experienced physicians and nurses that has been implemented in various institutions in German-speaking Switzerland (e.g., ETH Zurich Medical School, Bern University of Applied Sciences, Careum Postgraduate School Aarau, ACP Swiss interprofessional training, University Hospital Zurich). We present its core elements consisting of blended learning units (serious moral games, e-learning elements), thematic lectures and training sessions with simulated patients covering specific aspects of the ACP process. These core elements can be taught and trained in different educational contexts and deepened at various levels from ‘beginners’ to ‘experts’. They help effectively to monitor learning outcomes and promote ongoing student engagement in using ACP application, demonstrated by our evaluation.

Conclusions A longitudinal curriculum for Advance Care Planning and goals of care can be successfully implemented and is rated as useful by learners, students, and professionals alike.

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