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

Abstract

<b><i>Background:</i></b> Funding and limited resources are barriers to required training of residents in serious illness conversation (SIC) skills. <b><i>Objectives:</i></b> To examine the effectiveness of a low-cost, low-resource (LCLR) SIC training embedded within a required palliative care rotation. <b><i>Design:</i></b> Pre-post prospective cohort study design. <b><i>Setting/Subjects:</i></b> 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. <b><i>Measures:</i></b> SIC competence checklist measured within simulated patient encounters longitudinally. <b><i>Results:</i></b> 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. <b><i>Conclusions:</i></b> LCLR SIC training for IM residents significantly increased the sustained use of basic SIC skills, but was less effective for more complex skills.