Clinical Simulation Training to Improve End-of-Life Communication Skills

Physicians often are criticized for the quality of their communication skills, in general, and particularly in end-of-life discussions. To assess the effects of simulation-based training on clinicians' end-of-life communication skills, investigators randomized about 470 internal medicine residents and nurse practitioner trainees in two medical centers to eight 4-hour communication skills sessions or to usual education. Communication training involved didactic teaching, small-group discussion, and communication-skills practice using trained, simulated patients and family members. Sessions focused on end-of-life issues including talking about advanced directives, holding family conferences, discussing resuscitation status, and arranging hospi…