EM Talk: Case-Based Communication Training for Emergency Medicine

The Emergency Department (ED) visit for a patient with serious illness represents a sentinel event, signaling a change in the illness trajectory. By better understanding patients’ wishes, emergency physicians can operationalize goals of care and ensure the care provided matches the patients’ values and preferences. Despite their importance in care at the end of life, emergency physicians have received little training on how to talk to seriously ill patients and their families about goals of care. To expand communication skills training to emergency medicine, Dr. Grudzen developed a program to give emergency physicians the ability to empathically deliver serious news and to talk about goals of care. She built on lessons from prior studies to design an intervention employing the most effective pedagogical techniques, including the use of simulated patients/families, role-playing, and small group learning with constructive feedback from master clinicians. Here she describes the methodology for the creation of the evidence-based communication skills training course EM Talk using simulation, reflective feedback, and deliberate practice. The goal is to disseminate a new emergency medicine communication paradigm and scale it for a national audience. This new communication paradigm will transform how emergency physicians assess and operationalize goals of care, improving the delivery of emergency care for diverse and vulnerable populations with serious illness.