Low-Cost, Low-Resource Training Model to Enhance and Sustain Serious Illness Conversation Skills for Internal...

Funding and limited resources are barriers to required training of residents in serious illness conversation (SIC) skills. To examine the effectiveness of a low-cost, low-resource (LCLR) SIC training embedded within a required palliative care rotation. Pre-post prospective cohort study design. Second year internal medicine (IM) residents received an LCLR three-hour training in the SIC Guide (SICG) with a single-faculty member and paired-participant practice replacing actors during a required two-week palliative medicine rotation. SIC competence checklist measured within simulated patient encounters longitudinally. Twenty resident average SIC checklist scores improved from 11 (95% confidence interval [CI] 9-13) at the beginning of rotation to 19 (95% CI 17-20) at the end of rotation and 18 (95% CI 16-20) at six months after the rotation. LCLR SIC training for IM residents significantly increased the sustained use of basic SIC skills, but was less effective for more complex skills.