Development and evaluation of a program to strengthen first year residents' proficiency in leading end-of-life discussions

Am J Hosp Palliat Care. 2011 Aug;28(5):328-34. doi: 10.1177/1049909110391646. Epub 2010 Dec 13.

Abstract

Purpose: Multiple interventions have been developed to teach and improve internal medicine residents' end-of-life communication skills, but have not been easily adaptable to other institutions. The purpose of this study was to develop and evaluate a program to enhance physicians' end-of-life communication with families of dying patients using a format that could be incorporated into an existing curriculum for first-year internal medicine residents.

Methods: An end-of-life educational program was developed and evaluated in the context of educating first-year residents at an urban academic medical center during the 2008-2009 academic year. The program consisted of three sessions including an interactive workshop flanked by pre- and post-workshop evaluations in simulated encounter and clinical vignette formats. Simulated encounters were recorded on video and residents' performances were rated by two independent observers using a 23 point checklist.

Results: Complete data were available for 24 (73%) of 33 residents who participated in the program. The residents' checklist scores increased significantly from a mean of 48.1 at baseline to 73.9 at follow-up. The increase in the scores on the clinical vignettes was also statistically significant, but of lesser magnitude.

Conclusions: A short, focused intervention can have significant impact on residents' communication skills in the setting of an end-of-life objective structured clinical examination (OSCE).

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Competency-Based Education / methods*
  • Curriculum
  • Female
  • Follow-Up Studies
  • Humans
  • Internal Medicine / education*
  • Internship and Residency / methods*
  • Male
  • Middle Aged
  • Palliative Care / methods*
  • Physician-Patient Relations
  • Professional Competence / standards*
  • Program Evaluation