An Educational Intervention To Improve Resident Comfort with Communication at the End of Life
Abstract
BACKGROUND: Approximately 20% of deaths in the United States occur in the intensive care unit (ICU). Physician trainees lack the practical communication skills required for end-of-life care, including establishing patient preferences, participating in shared decision making, discussing prognosis, and delivering bad news. Utilizing facilitated, case-based, peer interactions, we sought to assess the feasibility and impact of a novel resident curriculum in end-of-life education. METHODS: The study took place at each of the three University of California, San Francisco (UCSF) teaching hospitals, and involved all internal medicine residents at UCSF. The curriculum consisted of two one-hour lunch conference sessions and six one-hour morning reports. A pre- and post-intervention electronic survey was administered. RESULTS AND DISCUSSION: The teaching sessions offered in this study were well-attended and well-received by residents. Our curriculum impacted resident reports of comfort with specific topics in end-of-life care, including discussions of code status and comfort care. Furthermore, we found that this curriculum, although brief, demonstrated a small impact on resident reports of self-efficacy for communication. Our findings demonstrate the feasibility of incorporating end-of-life communication skills training into an existing internal medicine resident curriculum.
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The training programs significantly increased healthcare professionals' confidence.
“confidence [19, 25]”
From A systematic review of the effects of advance care planning facilitators training programs. (2019) · cites this paper as [25]
Perceived level of adequate training for EOL care was improved.
“Improved rating of perceived levels of adequate training for EOL care was found by Wilson et al. [25, 26].”
From A systematic review of the effects of advance care planning facilitators training programs. (2019) · cites this paper as [25]
The training programs significantly increased healthcare professionals' comfort in discussing EOL issues.
“comfort [20, 25, 26]”
From A systematic review of the effects of advance care planning facilitators training programs. (2019) · cites this paper as [25]
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- Authors
- Smith, L., O'Sullivan, P., Lo, B., & Chen, H.
- Affiliations
- University of California, San Francisco (US)
- University of California, San Francisco, San Francisco, California.
- Corresponding author
- Smith, Leah
- Venue
- Journal of Palliative Medicine
- Publisher
- SAGE Publications
- Published
- 2013-01
- Volume
- 16
- Issue
- 1
- Pages
- 54-59
- ISSN
- 1096-6218 (ISSN-L)
- 1557-7740
- OpenAlex
- W2028739844
- Cited by
- 53
- References
- 27
- Citations by year
- 2026: 3 · 2025: 2 · 2023: 4 · 2022: 2 · 2021: 7 · 2020: 4 · 2019: 5 · 2018: 3 · 2017: 2 · 2016: 6 · 2015: 9 · 2014: 4 · 2013: 2
- FWCI
- 4.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Palliative Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- end-of-life communication, physician-patient communication, internal medicine residents, communication skills training, end-of-life education, shared decision-making, breaking bad news, code status discussions, comfort care, self-efficacy, ICU mortality, curriculum feasibility
- MeSH terms
- Adult, Curriculum, Decision Making, Female, Humans, Internal Medicine, Internship and Residency, Male, Physician-Patient Relations, Pilot Projects, Prospective Studies, San Francisco, Terminal Care, Truth Disclosure, Program Evaluation, Self Efficacy, Patient Preference
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