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

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

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  • 1Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. donnamw78@gmail.com



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.


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.


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.


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).

[PubMed - indexed for MEDLINE]
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