The Impact of Resident Training on Communication with Families in the Intensive Care Unit. Resident and Family Outcomes.

Rationale: In high-acuity settings such as intensive care units (ICUs), the quality of communication with patients' families is a particularly important component of care. Evidence shows that ICU communication is often inadequate and can negatively impact family outcomes.

Objectives: To assess the impact of a communication training program on resident skills in communicating with families in an ICU and on family outcomes.

The project on death in America faculty scholars program: a report on scholars' progress.

Background: The Project on Death in America's (PDIA) Faculty Scholars' Program (FSP) was created to develop a cadre of faculty and clinician leaders in palliative care. The purpose of this study was to document Scholars' progress since their participation in this program.

Methods: Key outcome variables included grants awarded in palliative care, peer-reviewed publications, academic promotions, editorships held, honors, and certifications since their FSP grant award.

Questioning care at the end of life.

Background: The goal of the larger study was to explore physicians' emotional responses to the death of their patients; this study analyzed a subset of physician transcripts to elucidate the construct of questioning care, which emerged from the larger study.

Objective: To analyzes how physicians question care-expressing concern, unease, or uncertainty about treatment decisions and practices, errors, or adverse events-as they attend dying patients.

Design: Retrospective interview study of physicians caring for randomly selected deaths on the medical service of a major academic teaching hospital, using qualitative and quantitative measures.

"It was haunting...": physicians' descriptions of emotionally powerful patient deaths.

Purpose: To understand the emotional experiences of physicians who care for dying patients and to identify educational opportunities for improving patient care and physician well-being.

Method: Between 1999-2001, physicians at two quaternary care medical centers in Boston, Massachusetts, and Pittsburgh, Pennsylvania, participated in 90-minute, semistructured personal interviews on their most emotionally powerful patient death. Quantitative data was obtained through face-to-face surveys rated on ten-point scales that asked physicians about emotional characteristics of and emotional responses to the death.

Narrative nuances on good and bad deaths: internists' tales from high-technology work places.

Public and professional discourses in American society about what constitutes a "good death" have flourished in recent decades, as illustrated by the pivotal SUPPORT study and the growing palliative care movement. This paper examines a distinctive medical discourse from high-technology academic medical centers through an analysis of how physicians who are specialists in internal medicine tell stories about the deaths of patients in their care. 163 physicians from two major academic medical centers in the United States completed both qualitative open interviews and quantitative attitudinal measures on a recent death and on the most emotionally powerful death they experienced in the course of their careers.

Doctors' emotional reactions to recent death of a patient: cross sectional study of hospital doctors.

Objectives: To describe doctors' emotional reactions to the recent death of an "average" patient and to explore the effects of level of training on doctors' reactions.

Design: Cross sectional study using quantitative and qualitative data.

Setting: Two academic teaching hospitals in the United States.