Palliative and end of life care communication as emerging priorities in postgraduate medical education.
Reliance on surveys and qualitative studies of trainees to guide postgraduate education about palliative and end of life (EOL) communication may lead to gaps in the curriculum. We aimed to develop a deeper understanding of internal medicine trainees' educational needs for a palliative and EOL communication curriculum and how these needs could be met.



Mixed methods, including a survey and focus groups with trainees, and interviews with clinical faculty and medical educators, were applied to develop a broader perspective on current experiences and needs for further education. Quantitative descriptive and thematic analyses were conducted.



Surveyed trainees were least confident and least satisfied with teaching in counseling about the emotional impact of emergencies and discussing organ donation. Direct observation with feedback, small group discussion, and viewing videos of personal consultations were perceived as effective, yet infrequently identified as instructional methods. Focus groups and interviews identified goals of care conversations as the highest educational priority, with education adapted to learner needs and accompanied by feedback and concurrent clinical and organizational support.



Our work expands on previous research describing needs for postgraduate education in palliative and EOL communication to include the importance of support, culture change, and faculty development, and provides insight into why such needs exist.
Department of Critical Care and Division of Palliative Medicine, University of Calgary.
Amanda
A
Roze des Ordons
Centre for Research in Assessment and Digital Learning, Deakin University, Melbourne, Australia.
Rola
R
Ajjawi
Division of Critical Care Medicine, University of Ottawa; Department of Anesthesia, University of Ottawa.
John
J
Macdonald
Division of Critical Care Medicine, University of Ottawa; Division of Palliative Medicine, University of Ottawa.
Aimee
A
Sarti
Department of Community Health Sciences, University of Calgary.
Jocelyn
J
Lockyer
Division of Critical Care Medicine, University of Ottawa; Division of Palliative Medicine, University of Ottawa.
Michael
M
Hartwick
Communication skills; End of life care; Mixed methods; Palliative care; Postgraduate medical education