Corita Grudzen

Corita Grudzen

Discipline: Physician
Funding awarded to: NYU School of Medicine, New York City

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.

I chose to pursue a career in medicine to relieve patients’ suffering. I was attracted to emergency medicine because of its core mission to treat patients regardless of insurance or legal status, as well as for the window the ED provides to public health problems. Although advances in medical technology and clinical research have made it possible to restore physical functioning for some patients with acute illness and injury, a significant number of ED patients have serious, life-limiting illness, and they are often in physical, emotional, and/or financial crisis. This led me to pursue a career at the cultural divide between emergency medicine and the new subspecialty of palliative care, where multiple opportunities exist for decreasing symptom burden, improving quality of life, and aligning care with patient goals. Caring for patients in the clinical setting informs what is important in my research, and research allows me the opportunity to influence structural changes in the broader health care system.