Digital Educational Interventions for the Development of Advanced Care Planning Skills for Medical Practitioners: A Scoping Review.

Abstract

Background: Medical practitioners are important facilitators of advanced care planning but are often reluctant to engage in these conversations with patients and their families. Barriers to participation can be addressed through medical education for medical practitioners.

Introduction: The primary objective was to examine the extent to which digital educational interventions are used to foster advanced care planning skills. Secondary objectives include understanding the acceptability of these interventions and whether electronic health records can be used to personalize learning.

Methods: Online databases were used to identify relevant articles published from 2008 to 2021. Nine articles which evaluated the impact of digital learning for medical practitioners were selected. Studies eligible for inclusion in the review assessed changes in knowledge, attitudes, and practice regarding skills used in advanced care planning.

Results: All publications used a pre-post study design with education delivered solely online. Only three studies focused on completing advance care plans or directives (33%). All but two studies recorded improvements in knowledge and/or attitudes toward planning (78%) while three studies recorded improvements in clinical practice (33%). The review suggests prior clinical or personal experiences could be used to personalize education.

Discussion: The literature revealed that using digital education to develop advanced care planning skills is relatively unexplored despite the ability of this type of learning to improve professional knowledge and confidence. Digital devices can also improve access to relevant information at the point-of-care. Personalized interventions that incorporate prior clinical experiences, potentially extracted from health records, could be used to optimize outcomes.