title: Goals of care conversation teaching in residency - a cross-sectional survey of postgraduate program directors.
abstract: BACKGROUND
  Residents are commonly involved in establishing goals of care for hospitalized patients. While education can improve the quality of these conversations, whether and how postgraduate training programs integrate such teaching into their curricula is not well established. The objective of this study was to characterize perceptions of current teaching and assessment of goals of care conversations, and program director interest in associated curricular integration.
  
  
  METHODS
  An electronic survey was sent to all postgraduate program directors at the University of Calgary. Quantitative data was analyzed using descriptive statistics and qualitative comments were analyzed using thematic analysis.
  
  
  RESULTS
  The survey response rate was 34% (22/64). Formal goals of care conversation teaching is incorporated into 63% of responding programs, and most commonly involves lectures. Informal teaching occurs in 86% of programs, involving discussion, direct observation and role modeling in the clinical setting. Seventy-three percent of programs assess goals of care conversation skills, mostly in the clinical setting through feedback. Program directors believe that over two-thirds of clinical faculty are prepared to teach goals of care conversations, and are interested in resources to teach and assess goals of care conversations. Themes that emerged include 1) general perceptions, 2) need for teaching, 3) ideas for teaching, and 4) assessment of goals of care conversations.
  
  
  CONCLUSIONS
  The majority of residency training programs at the University of Calgary incorporate some goals of care conversation teaching and assessment into their curricula. Program directors are interested in resources to improve teaching and assessment of goals of care conversations.
authors.affiliation: Department of Critical Care Medicine and Division of Palliative Medicine, University of Calgary Cumming School of Medicine, South Health Campus ICU, 4448 Front St. SE, Calgary, AB, T3M 1M4, Canada. amanda.rozedesordons@ucalgary.ca.
authors.forename: Amanda
authors.initials: A
authors.lastname: Roze des Ordons
authors.affiliation: Office of Postgraduate Medical Education, Cumming School of Medicine, University of Calgary Cumming School of Medicine, Heritage Medical Research Building, Room G02 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada.
authors.forename: Aliya
authors.initials: A
authors.lastname: Kassam
authors.affiliation: Division of Palliative Medicine, University of Calgary Cumming School of Medicine, Foothills Medical Center, South Tower, Room 710 1403 29th St. NW, Calgary, AB, T2N 2T9, Canada.
authors.forename: Jessica
authors.initials: J
authors.lastname: Simon
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D003142:Communication; D003430:Cross-Sectional Studies; D003479:Curriculum / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards*; D006040:Goals; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D010347:Patient Care Planning / Q000592:standards; D011795:Surveys and Questionnaires; D013663:Teaching / Q000592:standards*