Abstract Rationale Serious illness communication (SIC) among patients, families, and clinicians is a key component of high-quality critical care. When done effectively, SIC promotes goal concordant care, improves patient, family, and clinician satisfaction, and represents a high value intervention. In academic medical centers, resident physicians often lead these discussions. Core competencies in internal medicine residency (IMR) include providing patient-centered care that respects individual differences, preferences, and needs, while effectively communicating diagnosis and treatment plans. However, trainees report variable training and comfort with SIC skills, including discussion of goals of care. Few SIC curricula exist in IMR training nationally to directly address this gap, and training needs likely vary by program depending on the patient population and available resources. Methods We conducted a needs assessment among a single, academic institution’s IMR, and subsequently created a longitudinal, multidisciplinary SIC curriculum for the intensive care unit (ICU), hospital ward, and ambulatory settings. The ICU component included a “just in time” lecture provided to trainees at the start of their rotation based on the SIC guide from Ariadne Labs. Participants completed interval surveys during ICU rotations on knowledge and confidence in SIC. Results Following 6 pilot sessions, 14 residents (11 PGY-1, 2 PGY-2, 1 PGY-3) responded to the survey. Less than half of residents (47%) were familiar with the SIC guide prior to the session and only 1 (7%) reported routine use. Half reported confidence in discussing goals of care, with one-third (35%) reporting confidence with discussing risks and benefits of life-sustaining treatments. About 80% reported routinely eliciting values and preferences from patients/families, with 57% reporting providing recommendations. Only 35% reported routinely discussing prognosis. Limitations include small sample size and low response rate. Conclusions During IMR, there is a need for ongoing education about SIC, with a particular focus on risks versus benefits of life sustaining treatments and discussion of prognosis in the ICU setting. Follow up surveys will provide insight into whether this is a modality to sustainably increase resident knowledge of and confidence in serious illness communication. This pilot curriculum will also inform a larger scale SIC curriculum across inpatient and ambulatory IMR training that will include simulation and direct observation. This abstract is funded by: None
Vollbrecht et al. (2026) studied this question.