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National Center for Ethics in Health Care

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Goals of Care Conversations Training for Physicians, Advance Practice Nurses, & Physician Assistants

Doctor comforts patient

This training program consists of flexible, interactive modules to help practitioners improve their skills in delivering serious news and discussing goals of care and life-sustaining treatment decisions with seriously ill patients. It is intended for practitioners who care for patients with serious illness in outpatient, inpatient, long-term care, and home care settings.

Training Materials

Delivering Serious News

Slides with Facilitator Notes and Embedded Videos

Windows Media compatible - Updated September 2019
QuickTime compatible - Updated September 2019
Windows Media compatible – open captioned - Updated September 2019
QuickTime compatible – open captioned - Updated September 2019

Drills Handout - Updated September 2019
SPIKES Card

Goals of Care Conversations
Part 1: Reframing and Expecting Emotion

Slides with Facilitator Notes and Embedded Videos

Windows Media compatible - Updated September 2019
QuickTime compatible - Updated September 2019
Windows Media compatible – open captioned - Updated September 2019
QuickTime compatible – open captioned - Updated September 2019

Drills Handout - Updated September 2019
REMAP Card

Goals of Care Conversations
Part 2: Mapping the Future

Slides with Facilitator Notes and Embedded Videos

Windows Media compatible - Updated September 2019
QuickTime compatible - Updated September 2019
Windows Media compatible – open captioned - Updated September 2019
QuickTime compatible – open captioned - Updated September 2019

Drill Handout - Updated September 2019

Goals of Care Conversations
Part 3: Aligning with Patient Goals

Slides with Facilitator Notes and Embedded Videos

Windows Media compatible - Updated September 2019
QuickTime compatible - Updated September 2019
Windows Media compatible – open captioned - Updated September 2019
QuickTime compatible – open captioned - Updated September 2019

Drills Handout - Updated September 2019

Goals of Care Conversations
Part 4: Discussing Life-Sustaining Treatments

Slides with Facilitator Notes - Updated September 2019
Drills Handout - Updated September 2019
CPR Outcomes Handout

Putting It All Together
Practice Exercise

Slides with Facilitator Notes - Updated September 2019
Drills Handout - Updated September 2019

Additional Training Resources

All Drills Handouts – to print all at once, rather than by module - Updated September 2019
Empathic Responses Handout - Updated September 2019
Goals of Care Conversations Worksheet for MDs/APRNs/PAs
Prognostication Slides
Values Exercise - NEW!
Communication Skills Drills Video - NEW!

Customizing Training to Meeting Learners’ Needs Slides

Windows Media compatible - Updated September 2019
QuickTime compatible - Updated September 2019
Windows Media compatible – open captioned - Updated September 2019
QuickTime compatible – open captioned - Updated September 2019

Goals of Care Conversations Training for Nurses, Social Workers, Psychologists, and Chaplains

GoCC training resources for nurses, social workers, psychologists, and chaplains

VA Life-Sustaining Treatment Decisions Initiative (LSTDI) Resources


Patient Education Materials

Goals of Care Conversations training materials are available for public use.

When using these materials outside of VA, please include this attribution:

U.S. Department of Veterans Affairs National Center for Ethics in Health Care. Goals of Care Conversations Training for Physicians, Advance Practice Registered Nurses, and Physician Assistants. https://www.ethics.va.gov/goalsofcaretraining/practitioner.asp. Updated January 3, 2019. Accessed [date].

When citing this page, please use this format:

U.S. Department of Veterans Affairs National Center for Ethics in Health Care. Goals of Care Conversations Training for Physicians, Advance Practice Registered Nurses, and Physician Assistants website. https://www.ethics.va.gov/goalsofcaretraining/practitioner.asp. Updated January 3, 2019. Accessed [date].