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Goals of Care: Outpatient Planning

Facilitate a proactive goals of care discussion with a stoic, pragmatic patient newly diagnosed with a terminal illness.

  1. 1
    Briefing
  2. 2
    Simulation
  3. 3
    Feedback

How This Works

This is an interactive phone call simulation. You'll speak with Mr. Thompson in a realistic clinical communication scenario.

1. Start Call

Click "Start Call" when you're ready. Speak naturally as you would on a real call.

2. Have the Conversation

10 minutes to complete the call. The AI responds in real-time to what you say.

3. Get Feedback

End the call when finished. You'll receive AI-powered feedback on your communication.

💡 Tip: Speak clearly and at a natural pace. If you need a moment to think, it's okay to pause briefly - just as you would in a real conversation.

Briefing Details

1. Learning: Proactive Advance Care Planning

Purpose of this Scenario

Goals of care conversations are not just for crises. One of the most impactful times to have these discussions is in the outpatient setting, shortly after a life-limiting diagnosis, when the patient has time and full capacity to reflect on their values. This simulation focuses on facilitating, rather than directing, a conversation about what matters most to a patient and how their medical care can align with those goals.

Key skills include:

  • Opening the conversation in a non-alarming way.
  • Using open-ended questions to explore patient values.
  • Explaining the difference between palliative care and hospice.
  • Introducing advance directives like living wills and healthcare proxy forms.

2. Scenario Briefing: The New Terminal Diagnosis

Your Objective

You are an oncologist in an outpatient clinic. Your objective is to have an initial goals of care discussion with Mr. Thompson, a 68-year-old man you have just diagnosed with metastatic pancreatic cancer. Your goal is to explore his understanding of his prognosis, elicit his values, and introduce the concept of palliative care as an added layer of support.

Patient Background

Mr. Thompson is a 68-year-old retired engineer who presented with painless jaundice. A workup has confirmed metastatic pancreatic cancer. You have just delivered the diagnosis to him in a prior conversation. This is the follow-up visit to discuss the plan.

Crucial Information: Mr. Thompson is stoic and pragmatic. He is not emotional or in denial. He understands the gravity of his diagnosis and wants to approach "what's next" in a logical, planned manner.

Key Medical Facts

  • Diagnosis: Metastatic pancreatic adenocarcinoma.
  • Prognosis: This is a terminal diagnosis. While palliative chemotherapy can extend life, the median survival is on the order of months to a year.
  • Plan: You are planning to offer palliative chemotherapy to manage symptoms and prolong life, but the focus of this conversation is on the bigger picture.

Learning Objectives

Optional prep details

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Optional Pre-Call Knowledge Check

Optional self-check before you start

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This scenario requires an account. Sign in to begin the simulation.

After completing this scenario, you will be able to:

  • Analyze a patient's stated values and pragmatic worldview to collaboratively define goals of care.
  • Differentiate between directing a conversation with a pre-set agenda and facilitating a patient-led exploration of priorities.
  • Identify key moments to introduce advance care planning documents (e.g., living will, healthcare proxy) in a natural, non-coercive manner.

What is the primary advantage of conducting a goals of care discussion in an outpatient setting shortly after a terminal diagnosis, as opposed to during a hospital crisis?

When engaging a stoic and pragmatic patient about their goals, which communication technique is most effective?

What is the key difference between a living will and a healthcare proxy?