# Why did he say that? Teaching physicians-in-training how to recognize hidden emotions in end-of-life prognosis conversations: an autoethnography

## TL;DR

This paper explores how training physicians to recognize hidden emotions can improve end-of-life conversations with patients and families.

## Contribution

The paper proposes customizing Spiritual Care’s 'Verbatim' modules for physicians-in-training to address emotional blunders in end-of-life communication.

## Key findings

- Physicians' communication blunders in end-of-life conversations are often rooted in unexplored emotions.
- The 'Verbatim' modules offer revelatory self-knowledge and emotional intelligence when applied to physician training.
- Customizing these modules for physicians may improve clinical communication and emotional self-awareness.

## Abstract

Background: This article begins with two unconscionable end-of-life prognosis-related quotes from NY Times best-selling physician-author, Atul Gawande, and an unnamed physician, asking: “Why did he say that?” Intuitively linked from WhyDidHeSayThat.com, the article then proceeds to answer this question by showing how physicians’ most common end-of-life communication blunders are rooted in their unexplored emotions. Healthcare’s only widespread conversation analysis training focused on examining the role of hidden emotions in influencing the flow of conversation is found in Spiritual Care’s “Verbatim” education modules. While the need for physicians’ emotional self-awareness for improved end-of-life communication has been identified in the literature, no one has explored how this need might be met by custom-tailoring Spiritual Care’s “Verbatim” education modules for physicians-in-training.

Methods: This article utilizes the qualitative research method of autoethnography to grant physicians access to the content and power of Spiritual Care’s “Verbatim” education modules for conversation analysis and emotional intelligence.

Results: Using a profound personal example from the author’s firsthand experience of the suggested training tool, the “Verbatim” module is shown to grant revelatory self-knowledge and invaluable emotional intelligence.

Conclusion: Spiritual Care’s “Verbatim” education modules address universal issues of clinical communication and emotional self-awareness that are applicable to physician-patient/family conversations surrounding end-of-life decision-making. Customizing these communication modules for physicians-in-training may be the best solution to the problem of physicians’ emotionally-triggered conversational miscues in end-of-life prognosis communication. Existing programs for complementary end-of-life communication training are noted, and it is claimed that a combination of each of these models, together with the proposed module, may be ideal.