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ACP documentation increased from 19.5% in Y 1 to 57.2% in Y 3 (P 0.001). Time to ACP documentation was reduced from 47.6 to 13.1 h (P 0.001) from time of admission. ICU LOS decreased from 6 to 4.8 d (P=0.004). Patients in Y 3 had fewer tracheostomies and percutaneous endoscopic gastrostomies. PC consultations decreased. Mortality was unchanged. Following trainee education, we observed increases in ACP documentation, earlier communication and improvements in ICU quality measures. Our findings suggest that trainee education posi
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