Improving internal medicine residents’ confidence in oncology goals-of-care conversations.

Abstract

TPS9047 Background: Internal medicine (IM) residents frequently participate in goals-of-care (GOC) discussions for patients with cancer, yet formal training in oncology-specific serious illness communication remains limited across residency programs. As a result, residents often rely on oncology or palliative care teams to lead these conversations, which may delay timely GOC discussions and subsequent care decisions. Prior educational interventions in serious illness communication have demonstrated improvements in resident confidence; however, oncology-specific GOC training tailored to IM residents is underrepresented. We aim to address this educational gap through the development of a brief, case-based curriculum focused on oncology-related GOC conversations. The objective is to evaluate whether a brief, case-based educational intervention improves IM residents’ confidence and knowledge in conducting oncology-related goals-of-care discussions. Methods: This is a pilot educational intervention involving IM residents (postgraduate years 1–3) at a large academic residency program. The intervention consists of a 60-minute, case-based session delivered during a scheduled conference. Content focuses on key oncology GOC topics, including prognostic uncertainty, transitions to comfort-focused care, transitions to palliative-intent treatment, and use of structured communication frameworks. Participants will complete pre- and post-intervention surveys assessing self-reported confidence in conducting GOC discussions, comfort discussing prognosis and treatment transitions, and knowledge using two brief case-based vignettes. Pre- and post-intervention survey responses will be compared using paired t-tests. Qualitative feedback will be collected and analyzed thematically.