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EM Talk: communication skills training for emergency medicine patients with serious illness
  1. Corita R Grudzen1,
  2. Lillian L Emlet2,
  3. Joanne Kuntz3,
  4. Ashley Shreves4,
  5. Erin Zimny5,
  6. Maureen Gang1,
  7. Monique Schaulis6,
  8. Scott Schmidt7,
  9. Eric Isaacs8 and
  10. Robert Arnold9
  1. 1Ronald O Perelman Department of Emergency Medicine and Population Health, New York University School of Medicine, New York, New York, USA
  2. 2Department of Critical Care Medicine and Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  3. 3Department of Traumatology and Emergency Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
  4. 4Department of Emergency Medicine, Mount Sinai Medical Center, New York, New York, USA
  5. 5Department of Emergency Medicine, Henry Ford Health System, Detroit, Michigan, USA
  6. 6Department of Emergency Medicine, Kaiser Permanente Health System, San Francisco, California, USA
  7. 7Department of Emergency Medicine, Kaiser Permanente, San Raphael, California, USA
  8. 8Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
  9. 9Department of Medicine, Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Corita R Grudzen, Bellevue Hospital Center, Ronald O. Perelman Department of Emergency Medicine, Research Division, 462 First Avenue, Room A862, New York, NY 10016, USA; corita.grudzen{at}


The emergency department visit for a patient with serious illness represents a sentinel event, signalling a change in the illness trajectory. By better understanding patient and family wishes, emergency physicians can reinforce advance care plans and ensure the hospital care provided matches the patient's values. 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, we developed a programme to give emergency medicine physicians the ability to empathically deliver serious news and to talk about goals of care. We have 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, we describe our evidence-based communication skills training course EM Talk using simulation, reflective feedback and deliberate practice.

  • Communication
  • Education and training

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