The purpose of this study is to investigate whether the addition of teaching on communication at the end of life to the pre-existing resident curriculum will positively impact residents' knowledge and attitudes regarding communication at the end of life.

Previous research has demonstrated a lack of resident training in communication at the end of life. This can lead to anxiety on the part of residents and poor experiences with these conversations. Residents at UCSF, and affiliated sites, participate in a daily formal teaching session from 12-1 pm and an informal case conference, known as Morning Report, from 7:30-8:30 am (8-9 am at VAMC). We propose to administer a pre-intervention survey to residents to assess knowledge and attitudes regarding communication at the end of life. Over two months, residents will receive one lecture during the noon session. Clinical cases will be presented for discussion during three sessions of morning report. All sessions are voluntary and take place at all three training sites, UCSF, SFGH, and the VAMC. As residents rotate every two months between the inpatient and outpatient settings, the intervention will be repeated once to ensure that the majority of residents have the opportunity to participate. A post-intervention survey, identical to the pre-intervention survey, will be administered to assess for impact of the educational intervention. This project only involves UCSF Internal Medicine residents. No patients will be involved in this study.

Inclusion Criteria:

• UCSF internal medicine resident

Exclusion Criteria:

• Not UCSF internal medicine resident