Practicing End-of-Life Conversations: Physician Communication Training Program in Palliative Care

Abstract

A Physician Communication Training Program (PCTP) utilizing scripts based on actual family conferences with patients, families, and the health care team was developed at one medical center in the Northeast. The program was designed, adapted, and directed by a palliative care social worker. The primary goal of the program is to help residents and attending physicians build better communication skills in establishing goals of care and in end-of-life planning. The scripts focus on improving physicians’ basic skills in conducting family meetings, discussing advance directives, prognosis, brain death, and withdrawal of life support. Excerpts from the scripts utilized in the program are included. Feedback from participants has been positive, with all respondents indicating improvement in their capacity to take part in these challenging conversations.

KEYWORDS:

• communication skills
• end-of-life conversations
• family meetings
• improvisation
• palliative care
• role-play

ACKNOWLEDGMENTS

Special thanks to champions of this program at The Brooklyn Hospital Center: Drs. Viswanath Vasudevan and Farzana Afroza, Fr. John O'Leary and Susanne Nicoletti-Krase, of the TBHC Ethics Committee. The authors are deeply grateful to Susan Gerbino, PhD, and Jocelyn Walls, MSW for their steadfast support and guidance in helping this paper come to fruition.