Clinicians often face difficult discussions about serious illness, prognosis, and care preferences, yet many lack formal training in the communication skills needed to navigate these conversations. This gap can lead to challenges in care delivery and clinical education. Researchers from The Institute for Education Research (TIER) at UHN explored how training clinicians in serious illness communication can build confidence in teaching and support a scalable approach to spreading these skills across health care teams.
Led by Dr. Warren Lewin, a TIER Clinician Investigator, the research team explored the experiences of 15 physicians and nurse practitioners from family medicine, palliative care, neurosurgery, internal medicine, and geriatrics as they completed an evidence-based course designed to help them learn and teach others to communicate effectively about serious illness.
Following the course, researchers administered surveys and interviews in which participants reported feeling more confident and comfortable both in having serious illness conversations and in teaching these skills. Many began using what they learned in their bedside teaching and clinical workshops. They valued the course’s structured approach and felt better equipped to teach serious illness communication skills and techniques. The course also fostered a sense of community across departments, laying the foundation for a shared teaching culture and continued skill development.
Participants noted that key supports—such as dedicated time for teaching, administrative assistance, access to ready-to-use teaching materials, and institutional support—are critical for applying the knowledge in clinical teaching and care settings.
These findings suggest that investing in clinician education can have a broad impact. As clinicians become more confident in teaching and using serious illness communication skills, patients and caregivers benefit from greater trust, reduced uncertainty, and more informed decision-making.
Dr. Helen James, first author of the study, was a former Palliative Medicine Clinical and Research Fellow at UHN.
At UHN, Dr. Warren Lewin, senior author of the study, is a Clinician Investigator at The Institute for Education Research, the Palliative Care Site Lead, and Director of The Conversation Lab at Toronto Western Hospital. He is also an Associate Professor in the Temerty Faculty of Medicine at the University of Toronto.
This work was supported by UHN Foundation.
James H., Forsey J., Albuquerque-Boutilier K., Gustin J., Lewin WH. An Educational Initiative Describing Clinician Teachers’ Experiences Following Serious Illness Communication Skills Faculty Development Training. Palliative Medicine Reports. 2025 May 26. DOI: 10.1089/pmr.2024.0073.