Tough Conversations: Development of a Curriculum for Medical Students to Lead Family Meetings

Yuya Hagiwara, Jeanette Ross, Shuko Lee, Sandra Sanchez-Reilly

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Few educational interventions have been developed to teach Family Meeting (FM) communication skills at the undergraduate level. We developed an innovative curriculum to address this gap. Methods: Fourth year medical students during 2011-2013 (n = 674) completed training for conducting a FM. To assess the effectiveness of this training, students completed a FM Objective Structured Clinical Exam (OSCE) that included 15 domains rated on a 1-5 point Likert scale. Tasks included discussing prognosis, establishing goals of care and demonstrating conflict resolution skills. Students received one-to-one feedback from standardized family members and faculty observers. Group debriefings with faculty were held after the OSCE. Results: Analysis of faculty feedback narratives revealed four themes in which students required improvement: 1) Discussing prognosis, 2) Explaining palliative care/hospice, 3) Avoiding medical jargon, and 4) Discussing cultural/religious preferences. Evaluation total mean score was 28.2 (Min 15, Max 63; SD 7.57), and identified student’s need to; 1) Ask more about the degree of knowledge family members want, 2) Ask religious beliefs, and 3) Assess family members’ level of education (p < 0.001). Qualitative analysis of group debriefings suggested that student perception of the OSCE experience was positive overall. Students found the case to be realistic and immediate feedback to be helpful. Conclusions: Conducting a FM is an advanced skill. This study shows that it is possible to train fourth year students to lead FMs and identify their strengths, needs using a FM OSCE.

Original languageEnglish (US)
Pages (from-to)907-911
Number of pages5
JournalAmerican Journal of Hospice and Palliative Medicine
Issue number10
StatePublished - Dec 1 2017


  • communication
  • family meetings
  • medical education
  • objective structured clinical exam
  • palliative care
  • undergraduate medical education

ASJC Scopus subject areas

  • General Medicine


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