Feasibility, acceptability, and effectiveness of serious illness conversation guide training for residents in the surgical intensive care unit

Goals of care conversations are essential for physicians treating critically ill patients in the surgical intensive care unit (SICU). However, many providers feel uncomfortable having these conversations. This study aimed to assess the feasibility, acceptability, and effectiveness of implementing training in the Serious Illness Conversation Guide (SICG) for residents in our institution’s SICU.

All residents rotating through our institution’s SICU during the 2021–2022 academic year completed SICG training. Training consisted of a 1.5-h pre-recorded lecture, pre-course reading, and quiz followed by a 1-h group session for participants to practice the SICG with standardized patients. Validated surveys were administered before, after, and at 1, 3, 6, and 12 months post-training to evaluate the acceptability and effectiveness of the training.

Training significantly increased residents’ mean confidence levels in conducting serious illness conversations (4.3 ± 0.4 vs. 5.4 ± 0.1, p < 0.001). Post-training, 92% of residents agreed or strongly agreed that the teaching methods were effective, 88% agreed or strongly agreed that the training positively impacted their attitude towards communicating with seriously ill patients, 88% agreed or strongly agreed that they could apply what they learned to their clinical practice, and 92% agreed or strongly agreed that they would recommend this training to others.

Training in the use of the SICG is feasible, acceptable, and effective for SICU residents at our institution. Residents reported an overall increase in confidence levels in conducting serious illness conversations and found the training applicable to their clinical practice.