Advanced Steps® ACP Facilitator Certification (formerly Last Steps®)

Last Steps® (LS) ACP is initiated as a component of quality end-of-life care for frail elders and those whose death in the next 12 months would not be unexpected. The LS planning conversation is focused on goals of care to make timely, proactive, and specific end-of-life decisions. Ideally, these decisions are converted into medical orders that can be followed throughout the continuum of care. The POLST: Portable Medical Orders Training program is the nationally recognized model for this stage of planning.

Advanced Steps® Advance Care Planning Certification Course

All courses will be held in person at:
Sanford 501 Place
501 4th St N
Fargo, ND

Marsha Nygaard and Chelle Lyons Hanson
First and Advanced Steps Instructors

Sanford Health Fargo
Phone 701-234-3757

Target Audience

The LS ACP Facilitator Certification course is intended for healthcare clinicians (nurses, social workers, chaplains, physicians) and others involved in assisting those with serious illness or frailty in making treatment decisions based on their goals of care.


The purpose of this program is to improve the effectiveness of the LS ACP through facilitation skills training.


  1. Describe the goals of LS, a POLST Paradigm program.
  2. Identify interview skills for facilitating LS conversations.
  3. Identify skills to assist individuals in making informed treatment decisions that include CPR, limitations on treatment, and comfort care.
  4. Develop strategies to create a POLST form that accurately reflects an individual’s treatment preferences.
  5. Identify systems to honor the POLST plan.
  6. Demonstrate beginning competency in facilitating LS conversations through role-play activities.

Initial Certification Requirements

  • Completion of the LS ACP Facilitator Certification Online Curriculum (Modules 1-4 and Module 5)
  • Completion of the LS ACP Facilitator Certification classroom training (8-hour classroom instruction)

Ongoing Certification Requirements

Currently, Respecting Choices (RC) has no recertification requirements. It is recommended that recertification requirements be established and monitored by the Facilitator’s sponsoring organization and RC Instructors. RC intends to establish recertification requirements in the future.