title: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of California, San Francisco, San Francisco, California 94143, USA. leah.smith@swedish.org
authors.forename: Leah
authors.initials: L
authors.lastname: Smith
authors.forename: Patricia
authors.initials: P
authors.lastname: O'Sullivan
authors.forename: Bernard
authors.initials: B
authors.lastname: Lo
authors.forename: Hubert
authors.initials: H
authors.lastname: Chen
mesh_terms: D000328:Adult; D003479:Curriculum; D003657:Decision Making; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D057240:Patient Preference; D010817:Physician-Patient Relations; D010865:Pilot Projects; D015397:Program Evaluation; D011446:Prospective Studies; D012495:San Francisco; D020377:Self Efficacy; D013727:Terminal Care; D014342:Truth Disclosure