Changes in internal medicine residents' attitudes about resuscitation after cardiac arrest over a decade

• Published in: Journal of critical care 2009-03, Vol.24 (1), p.141-144
• Main Authors: Deep, Kristy S., MD, Griffith, Charles H., MD, MSPH, Wilson, John F., PhD
• Format: Article
• Language: English
• Subjects: Academic Medical Centers; Advance Care Planning; Attitude of Health Personnel; Attitudes; Cardiac arrest; Cardiopulmonary resuscitation (CPR); Cardiopulmonary Resuscitation - education; Cardiopulmonary Resuscitation - mortality; Cardiopulmonary Resuscitation - trends; Cardiopulmonary Resuscitation - utilization; Communication; Critical Care; Decision Making; Education; Family - psychology; Female; Health Knowledge, Attitudes, Practice; Heart Arrest - mortality; Heart Arrest - therapy; Humans; Informed Consent; Internal Medicine - education; Internal Medicine - trends; Internship and Residency - trends; Kentucky; Male; Medical Staff, Hospital - education; Medical Staff, Hospital - psychology; Medical Staff, Hospital - trends; Patient Education as Topic; Pilot Projects; Surveys and Questionnaires; Survival Rate
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2007.12.012

Abstract Background Resident physicians' beliefs about cardiopulmonary resuscitation (CPR) may impact their communication with patients about end-of-life care. We sought to understand how these perceptions and experiences have changed in the past decade because both medical education and American society have focused more on this domain. Method We surveyed 2 internal medicine resident cohorts at a large academic medical center in 1995 and 2005. Residents were asked of their beliefs about survival after CPR, perceived patient understanding, and regret after attempted resuscitation. Residents in 2005 reported more numerical experience with CPR. Current internal medicine residents are more optimistic than the 1995 cohort about survival after an inpatient cardiac arrest. They believe that far fewer patients and families understand resuscitation but report less regret about attempting to resuscitate patients. Conclusions These pilot data reveal potential changes in the attitudes of resident physicians toward CPR. The perceived poor understanding among decision makers calls into question the standard of informed consent. Despite this, residents report less regret leading one to ask what factors may underlie this response.