Palliative and end of life care communication as emerging priorities in postgraduate medical education


  • Amanda Roze des Ordons University of Calgary
  • Rola Ajjawi University of Dundee
  • John Macdonald University of Ottawa
  • Aimee Sarti University of Ottawa
  • Jocelyn Lockyer University of Calgary
  • Michael Hartwick University of Ottawa



Palliative care, End of life care, Mixed methods, Communication skills, Postgraduate medical education


Background: Reliance on surveys and qualitative studies of trainees to guide postgraduate education about palliative and end of life (EOL) communication may lead to gaps in the curriculum. We aimed to develop a deeper understanding of internal medicine trainees’ educational needs for a palliative and EOL communication curriculum and how these needs could be met.

Methods: Mixed methods, including a survey and focus groups with trainees, and interviews with clinical faculty and medical educators, were applied to develop a broader perspective on current experiences and needs for further education. Quantitative descriptive and thematic analyses were conducted.

Results: Surveyed trainees were least confident and least satisfied with teaching in counseling about the emotional impact of emergencies and discussing organ donation. Direct observation with feedback, small group discussion, and viewing videos of personal consultations were perceived as effective, yet infrequently identified as instructional methods. Focus groups and interviews identified goals of care conversations as the highest educational priority, with education adapted to learner needs and accompanied by feedback and concurrent clinical and organizational support.

Conclusions: Our work expands on previous research describing needs for postgraduate education in palliative and EOL communication to include the importance of support, culture change, and faculty development, and provides insight into why such needs exist.

Author Biographies

Amanda Roze des Ordons, University of Calgary

Intensivist, Department of Critical Care Medicine

Palliative Medicine fellow, Division of Palliative Medicine

Rola Ajjawi, University of Dundee

Senior Lecturer, Centre for Medical Education

John Macdonald, University of Ottawa

Assistant Professor

Division of Critical Care Medicine and Department of Anesthesia

Aimee Sarti, University of Ottawa

Clinical Lecturer

Divisions of Critical Care and Palliative Medicine

Jocelyn Lockyer, University of Calgary

Senior Associate Dean of Education

Department of Community Health Sciences

Michael Hartwick, University of Ottawa

Assistant Professor

Divisions of Critical Care and Palliative Medicine




How to Cite

Roze des Ordons A, Ajjawi R, Macdonald J, Sarti A, Lockyer J, Hartwick M. Palliative and end of life care communication as emerging priorities in postgraduate medical education. Can. Med. Ed. J [Internet]. 2016Apr.2 [cited 2021Sep.28];7(1):e4-e21. Available from:



Major Contributions