An advance healthcare directive relias module is one of the most critical training units healthcare workers encounter on the Relias Learning platform. This module teaches staff how to recognize, document, and honor a patient's end-of-life wishes — a legal and ethical requirement across virtually every care setting in the United States.
An advance healthcare directive relias module is one of the most critical training units healthcare workers encounter on the Relias Learning platform. This module teaches staff how to recognize, document, and honor a patient's end-of-life wishes — a legal and ethical requirement across virtually every care setting in the United States.
Whether you are a new CNA, a seasoned RN, or an administrative coordinator, completing this module accurately directly affects patient outcomes, organizational compliance, and your professional standing. Understanding what the module covers before you sit down to complete it can dramatically reduce the time it takes and improve your assessment score.
Relias is one of the most widely used healthcare learning management systems in the country, and its training library spans hundreds of individual courses. From infection control and HIPAA compliance to dysrhythmia interpretation and cultural competency, the platform delivers mandatory continuing education to more than four million healthcare workers annually.
Many organizations require employees to complete assigned modules within strict deadlines, and failing a competency assessment attached to that module can delay onboarding, affect annual performance reviews, or even trigger disciplinary action. That is why knowing the landscape of what Relias offers — and how its assessments are structured — matters from day one.
The advance directive module fits inside a broader cluster of patient rights and regulatory compliance courses. These courses are not electives; they are required by federal regulations such as the Patient Self-Determination Act and by state-specific statutes that govern healthcare facilities receiving Medicare or Medicaid funding. A healthcare worker who cannot demonstrate competency in this area represents a liability risk for the organization, which is why Relias has designed the module with scenario-based questions that test applied knowledge rather than simple memorization.
If you want a broader orientation to what Relias offers as a company and how its curriculum is organized before diving into specific modules, exploring the full library of relias training courses will give you essential context. That overview covers how modules are assigned, how assessments are scored, and what remediation looks like when a learner does not pass on the first attempt. Having that foundation makes the rest of the material easier to absorb and apply.
One reason healthcare workers struggle with the advance directive module specifically is that it requires understanding legal terminology — living wills, durable power of attorney for healthcare, do-not-resuscitate orders, POLST forms — alongside clinical decision-making. The module does not just ask you to define these terms; it presents real-world scenarios and asks you to identify the correct course of action. For example, a question might describe a patient arriving unconscious without a family member present and ask you to determine whether a verbal statement the patient made previously constitutes a legally binding directive in your state.
Preparation strategies that work for other Relias modules also apply here. Reading the learning objectives listed at the beginning of the course before watching any video segments helps you filter for the most testable content. Taking notes on key definitions, especially those distinguishing one type of directive from another, builds the retrieval pathways you will need when answering scenario-based questions under time pressure. Pausing the video to reflect on each example scenario before the course presents the answer is a proven active-learning technique that improves retention significantly over passive viewing.
This guide walks you through everything you need to know about the advance healthcare directive module and the broader Relias training ecosystem: what topics are covered, how the assessments are structured, what scores are required to pass, and how to use free practice tests to prepare more efficiently. Whether you are completing this module for the first time as part of new-hire orientation or retaking a competency assessment for annual compliance, the strategies and information here will help you succeed.
These mandatory courses cover HIPAA, patient rights, advance directives, infection control, and abuse prevention. Completion is tracked and reported to licensing bodies and facility administrators. Most require a passing score of at least 80 percent on the embedded competency assessment.
Discipline-specific courses covering nursing fundamentals, dysrhythmia interpretation, medication management, wound care, and patient assessment. These modules often include video demonstrations, case simulations, and post-test questions that mirror real clinical decision-making scenarios.
New hires are assigned curated learning paths based on their job title and department. A CNA track differs significantly from an RN or social worker track. These paths ensure every employee meets baseline competency standards before working independently with patients.
Many modules auto-reassign each year to verify that staff have maintained their knowledge. Learners who score above a set threshold on the pre-test can sometimes skip the full course content, completing only the final assessment — a significant time-saver for experienced staff.
Relias partners with accrediting bodies to offer CE credit for nurses, social workers, and other licensed professionals. These courses require a higher standard of engagement and documentation, and certificates are automatically generated upon successful completion for license renewal purposes.
The advance healthcare directive module on Relias is designed to ensure that every healthcare worker understands the legal framework surrounding patient end-of-life decisions. At its core, the module distinguishes between the four primary directive instruments: the living will, the healthcare proxy or durable power of attorney for healthcare, the do-not-resuscitate (DNR) order, and the Physician Orders for Life-Sustaining Treatment (POLST) form.
Each instrument serves a different function, and conflating them in clinical practice can result in serious ethical and legal violations. Relias presents these distinctions through realistic scenario narratives that mirror the ambiguous situations healthcare workers actually face in the field.
A living will is a written document in which a competent adult specifies their wishes regarding medical treatment should they become unable to communicate. It typically addresses scenarios involving terminal illness, permanent unconsciousness, or end-stage conditions. The Relias module emphasizes that a living will is directive in nature — meaning it speaks directly to what the patient wants — but that it can only be activated under specific clinical conditions defined by state law. A healthcare worker's job is to identify when those conditions are met and to ensure the document reaches the appropriate clinical staff immediately.
The durable power of attorney for healthcare (DPOA-HC), by contrast, designates another person to make healthcare decisions on the patient's behalf when the patient cannot do so. This agent has broad decision-making authority, which may or may not be constrained by instructions in an accompanying living will. Relias quiz questions frequently test whether learners understand the hierarchy between these documents — for instance, what happens when the DPOA-HC agent makes a request that conflicts with instructions in the patient's living will.
DNR orders are physician orders, not patient directives in the strict sense, though they are typically issued in response to a patient's expressed wishes. The module covers the difference between in-hospital DNR orders and out-of-hospital DNR forms, which vary by state but generally must be signed by a physician and kept accessible by the patient. Healthcare workers are tested on their obligation to honor existing DNR orders even when family members verbally request resuscitation, which is one of the most ethically charged scenarios covered in the course.
POLST forms — known by different names in different states, including MOLST, MOST, or TPOPP — represent a newer evolution in advance care planning that translates a patient's wishes into actionable medical orders. Unlike a living will, a POLST is valid immediately and does not require a patient to be in a specific medical state before it takes effect. Relias tests healthcare workers on the difference between a POLST and a living will specifically because this distinction is frequently misunderstood and because acting on the wrong document type can constitute a medical error.
Beyond document types, the advance directive module also covers the healthcare worker's communication role. Staff are expected to ask about existing directives during the admissions process, document findings accurately in the electronic health record, and escalate unresolved situations to a supervisor or ethics committee. The Relias assessment includes questions on each of these procedural steps, meaning that preparation must go beyond understanding definitions to include understanding workflow and documentation requirements specific to the care setting.
For anyone looking to verify their knowledge before completing the Relias advance directive assessment, free practice resources focused on healthcare documentation and patient rights can be extremely valuable. These tools surface the question types that appear most frequently on Relias competency assessments and give learners the opportunity to identify knowledge gaps before they matter. Building this habit of pre-assessment practice applies equally well across the full spectrum of Relias modules, not just the advance directive course.
Relias assessments use three primary question formats: multiple-choice with a single correct answer, select-all-that-apply (SATA), and scenario-based questions that require the learner to read a clinical vignette before choosing the best response. SATA questions are considered the most difficult because partial credit is rarely awarded — learners must select every correct option and no incorrect options to receive full credit. The advance directive module relies heavily on scenario-based questions that test applied judgment rather than simple recall of definitions.
True/false and matching questions appear occasionally in shorter compliance modules, but they are less common in clinically-oriented courses where nuance matters. Relias also uses branching scenarios in some of its more advanced modules, where the answer to one question determines which follow-up question is presented next. These adaptive formats are designed to probe the depth of understanding and are increasingly common in annual competency reassessment modules across all care settings.
Most Relias competency assessments require a minimum passing score of 80 percent, though some organizations set their threshold higher — typically 85 or 90 percent for high-stakes clinical competencies such as medication administration or cardiac monitoring. The score is calculated as a percentage of correctly answered questions out of the total, with no penalty for incorrect answers on non-adaptive assessments. Learners who fall below the passing threshold are typically required to review the course content before attempting the retake, though the specific remediation requirements vary by organization and module type.
When a learner passes, a completion certificate is automatically generated and stored in their Relias learner profile. This certificate records the date of completion, the score achieved, the number of CE credits earned (if applicable), and the accrediting body that approved the course content. Administrators can pull completion and score reports at any time, which is how healthcare organizations demonstrate compliance during state surveys or Joint Commission accreditation reviews. Knowing this reporting infrastructure exists underscores why accuracy and genuine preparation matter far more than simply clicking through content.
Relias allows learners to retake failed assessments, but the number of allowed attempts and the waiting period between attempts are controlled by the organization's administrator settings. A common configuration is three attempts with a mandatory 24-hour waiting period after the second failure, during which the learner is expected to review the course material. Some organizations require supervisor approval before a third attempt is unlocked, treating repeated failure as a performance issue that warrants intervention and additional support from a clinical educator or preceptor.
Learners who exhaust all available retake attempts without passing are escalated to their manager or HR department, and the outcome can affect employment status for roles where the training is a condition of continued employment. For new hires, failing a critical compliance module during the orientation window can delay their start date on the floor and extend the supervised training period. Understanding retake rules before a first attempt is important because it removes the temptation to rush through without adequate preparation, knowing that a second chance is immediately available.
The single most commonly missed concept in the Relias advance directive module is the difference between a POLST form and a living will. A POLST is an active physician order that takes effect immediately and applies in all care settings; a living will is a patient statement that only activates under specific clinical conditions. On Relias assessments, scenario questions that describe an emergency situation and ask what document controls care are almost always testing this distinction — and the correct answer is nearly always the POLST when one exists.
Developing a concrete study strategy before you open a Relias module is the single most reliable way to improve both your assessment score and the time it takes to complete the course. Most healthcare workers approach Relias training the same way they approach watching a streaming video — passively, in the background, with minimal active engagement. This approach might get you through the content, but it rarely produces the deep encoding needed to answer complex scenario questions correctly, especially under the mild time pressure of a timed assessment.
The most effective technique is pre-reading the learning objectives. Every Relias module begins with a list of three to eight objectives that describe exactly what the course expects you to be able to do by the end. These objectives are not boilerplate; they are direct previews of the assessment domains.
If an objective says "distinguish between a living will and a durable power of attorney for healthcare," you can guarantee that at least one scenario question will test your ability to apply that distinction in a realistic clinical context. Writing the objectives down before you start the course content turns passive viewing into purposeful learning.
Active note-taking during the course itself compounds the benefit of pre-reading. You do not need to transcribe the course word-for-word; instead, focus on definitions, numerical thresholds, procedural steps, and any language the course emphasizes with visual cues like callout boxes or repeated narration. For the advance directive module specifically, note the exact conditions that must be present before each type of directive takes legal effect, because Relias scenario questions frequently hinge on whether those conditions are or are not present in the vignette.
Using practice questions before and after the course content is a technique that many healthcare workers overlook, primarily because they assume the course itself provides enough preparation. In reality, the course content and the assessment are two different cognitive tasks. The course asks you to receive and process information; the assessment asks you to retrieve and apply it under conditions that feel novel. Practice questions bridge this gap by training retrieval in a low-stakes environment where mistakes reveal gaps rather than trigger remediation requirements.
Spaced repetition is another strategy with strong research support that applies directly to Relias preparation. Rather than reviewing all your notes the night before you plan to complete the assessment, distribute your review across two or three shorter sessions over several days. Each review session should include some active recall — covering your notes and trying to state definitions from memory before checking them — rather than passive rereading. This approach is particularly useful for the legal and regulatory content in compliance modules, where precise terminology matters more than general understanding.
For scenario-based questions, practice reading for the decision point rather than for background detail. A Relias vignette will often include three to five sentences of clinical context followed by a question. Many of those context sentences are there to test whether you can identify the relevant detail among irrelevant noise — a skill that parallels real clinical reasoning. Train yourself to identify the decision-relevant information quickly: Who is the patient? What is their directive status? What is happening right now? What does the applicable rule or regulation require in this specific situation?
Finally, avoid the common mistake of skipping the review phase after a passed assessment. Reviewing the questions you missed — even on a passing attempt — identifies the topics where your knowledge is borderline rather than secure. Borderline knowledge is precisely what erodes over time and what creates vulnerability on the next annual reassessment. A few minutes of deliberate review after every Relias assessment, passed or failed, builds the cumulative competency base that makes future modules faster and easier to complete.
Once you have completed your Relias training modules and passed the associated assessments, understanding what happens to your records is just as important as the training itself. Relias generates a completion certificate for every successfully passed assessment, and this certificate is stored permanently in your learner transcript within the platform. The transcript records the course name, the date of completion, your score, the number of CE credits earned, and the accrediting organization — all the details you would need to provide to a licensing board, a new employer, or an accreditation reviewer.
Many healthcare workers do not realize that their Relias transcript is tied to their individual learner account, not to their employer's organization. This means that if you change jobs, you do not lose your completion history. You can request access to your personal transcript by contacting Relias support, and some organizations allow learners to export their transcript in PDF format directly from the learner dashboard. If your new employer uses Relias, it is worth asking their administrator whether completion records from your previous organization can be transferred or credited toward your new onboarding requirements.
CE credit management is a specific area where Relias provides significant value that healthcare workers sometimes fail to leverage. If you are a licensed RN, LPN, social worker, physical therapist, or occupational therapist, completing Relias courses that carry CE credit from an accredited provider can contribute directly to your license renewal requirements.
The key is to verify before you complete the course that the CE credit is from an accreditation body your state licensing board accepts. Relias lists the accrediting organizations for each course on the course description page, and it is worth taking 60 seconds to confirm compatibility before investing time in a course for CE purposes.
For organizations undergoing Joint Commission surveys, CMS inspections, or state health department reviews, Relias training records serve as primary-source documentation of staff competency. Administrators can pull summary reports showing which employees have completed which modules, what scores they achieved, and when reassessments are due. If you are in a management or charge nurse role, familiarizing yourself with the administrative reporting side of Relias is worthwhile — not just for your own compliance, but for supporting the staff you are responsible for supervising and developing.
Remediation workflows in Relias are another post-assessment feature worth understanding. When a learner fails an assessment, Relias can be configured to automatically assign a remediation pathway — typically the original course content plus additional readings or supplemental modules — that must be completed before a retake is unlocked. As a learner, engaging genuinely with the remediation content rather than clicking through it is important, because the retake assessment often includes slightly different question wording that tests the same concepts from new angles. The remediation content is designed to address the specific domains where the learner performed below the passing threshold.
Annual reassignment is the aspect of Relias that surprises many experienced healthcare workers who completed their initial training years ago. Even if you passed a module with a perfect score during onboarding, that module will reappear in your assigned curriculum each year until the organization removes it from the annual rotation.
The reason is straightforward: clinical guidelines change, regulations are updated, and knowledge degrades over time without reinforcement. The annual reassessment cycle ensures that all staff are operating from current information, and it provides organizations with a defensible paper trail demonstrating ongoing competency verification for all employees across all required domains.
For any healthcare worker navigating Relias for the first time or returning to it after an extended absence, the most important thing to remember is that the platform is a compliance tool first and a learning tool second. This means that the administrative record of your completion matters as much as the knowledge you acquire.
Always verify that your completions are saving correctly, that your CE credits are being attributed to the right accrediting organization, and that your transcript reflects your actual work history on the platform. Small administrative discrepancies caught early are far easier to resolve than gaps discovered during a licensing audit or a new employer background check.
Practical preparation for Relias training courses begins well before you log in to the platform. The most effective learners treat each module as a professional development event rather than an administrative checkbox, and that mindset shift produces measurably better outcomes on assessments.
One concrete way to shift your approach is to spend five minutes reading about the topic before you open the Relias module — a quick review of an authoritative source such as the CMS website, a professional association's fact sheet, or a peer-reviewed summary gives you a conceptual framework that makes the course content easier to organize and retain.
Time management is a practical concern that affects Relias completion rates across all care settings. Most healthcare workers are completing Relias modules in addition to their regular patient care or administrative responsibilities, not instead of them. This means that large modules assigned with a two-week deadline often get deferred until the last 48 hours, when time pressure forces rushed completion and reduces the quality of learning.
A more effective approach is to identify the total estimated completion time for all assigned modules at the beginning of each assignment cycle and then block specific calendar time for each module, treating those blocks as protected commitments rather than optional activities.
For modules that include video content, using the playback speed controls available in most browsers and within the Relias player itself can significantly reduce completion time without sacrificing comprehension. Most healthcare professionals can follow content presented at 1.25x or 1.5x speed, especially for material that covers familiar clinical concepts. This strategy is most appropriate for content review sections; slow down or return to normal speed for scenario presentations and any content that is genuinely new or particularly complex, since processing speed affects comprehension more when cognitive load is higher.
Study groups are an underused resource for Relias preparation, particularly in long-term care and hospital settings where multiple staff members are completing the same modules on similar timelines. Discussing scenario questions with colleagues after completing a module — particularly questions where you were uncertain or guessed — is one of the fastest ways to identify whether your reasoning aligns with the clinical and regulatory standards the module is testing. Colleagues who work in different units or have different clinical backgrounds often bring perspectives that illuminate aspects of a scenario that a single reader might miss.
For learners who have access to the Relias course content ahead of their scheduled completion date, previewing the final assessment before engaging with the course content is a powerful technique. Some Relias configurations allow learners to view assessment questions before completing the course. If this is available to you, reviewing the questions first — without answering them — gives you the most direct possible preview of what the course is testing. You can then watch the content with those specific questions in mind, dramatically increasing the signal-to-noise ratio of your learning time.
Documentation skills are worth practicing separately from clinical knowledge skills, because Relias assessments for compliance modules frequently include questions about documentation requirements that are procedural rather than clinical in nature. Know the correct terms for different types of documentation entries, understand the difference between a nursing note, a care plan entry, and a physician order, and be aware of the timeframes within which different types of documentation must be completed in your care setting. These are the details that often distinguish a 78-percent score from an 88-percent score on compliance-oriented Relias assessments.
Finally, recognize that Relias training is cumulative in the same way that clinical experience is cumulative. Each module you complete builds vocabulary, context, and frameworks that make subsequent modules easier to process.
The advance directive module, for example, is much easier to complete confidently after you have already completed the patient rights module, the HIPAA module, and the communication and documentation module — because each of those courses builds conceptual scaffolding that the advance directive course assumes you already have. Approaching your Relias curriculum as a coherent body of knowledge rather than a series of isolated tasks will improve both your efficiency and your long-term professional competency.