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

Donna M. Williams, Tamara Fisicaro, J. Jon Veloski, Dale Berg

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Purpose: 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).

Original languageEnglish (US)
Pages (from-to)328-334
Number of pages7
JournalAmerican Journal of Hospice and Palliative Medicine
Issue number5
StatePublished - Aug 2011
Externally publishedYes


  • clinical vignette
  • communication
  • end-of-life
  • interpersonal and communication skills
  • medical education
  • resident education
  • simulated encounter
  • standardized patient

ASJC Scopus subject areas

  • Medicine(all)


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