title: Development and evaluation of a program to strengthen first year residents' proficiency in leading end-of-life discussions.
abstract: OBJECTIVE
  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).
authors.affiliation: Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. donnamw78@gmail.com
authors.forename: Donna M
authors.initials: DM
authors.lastname: Williams
authors.forename: Tamara
authors.initials: T
authors.lastname: Fisicaro
authors.forename: J Jon
authors.initials: JJ
authors.lastname: Veloski
authors.forename: Dale
authors.initials: D
authors.lastname: Berg
mesh_terms: D000328:Adult; D003162:Competency-Based Education / Q000379:methods*; D003479:Curriculum; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D010817:Physician-Patient Relations; D011361:Professional Competence / Q000592:standards*; D015397:Program Evaluation