Goals of Care Discussions in Medical Training: Integrating Palliative Care for Holistic, Patient-Centered Care

Background: Goals of care discussions are essential communication skills in medical training that bridge patient values with clinical decision-making. Integrating palliative care principles into these conversations enables holistic, patient-centered care, yet medical trainees often lack structured preparation for these critical interactions. Objective: This narrative review examines how medical training can effectively integrate palliative care approaches into goals of care discussions through structured communication frameworks, interdisciplinary collaboration, and emerging innovations to promote patient-centered outcomes. Methods: Literature on evidence-based communication frameworks (SPIKES, REMAP, SUPER, Serious Illness Conversation Guide) was reviewed to identify training approaches. Clinical outcomes including patient satisfaction, hospice utilization, ICU transfers, and intervention intensity were examined. Educational barriers and facilitators—including communication training curricula, cultural competency, language considerations, and multidisciplinary team involvement—were evaluated. Emerging technologies supporting clinician education and practice were also assessed. Results: Training in structured communication frameworks improves patient-physician relationships, reduces patient anxiety, and increases family satisfaction. Early palliative care integration through effective discussions leads to increased hospice awareness and utilization while reducing burdensome interventions. Key educational facilitators include dedicated communication skills training, multidisciplinary team participation (including chaplains and palliative care specialists), and AI-assisted documentation tools that support learning while preserving humanistic clinician-patient interactions. Conclusions: Integrating palliative care principles into medical training for goals of care discussions is essential for developing patient-centered clinicians. Combining structured communication frameworks, interprofessional education, targeted skills training, and technological support creates a comprehensive educational approach that prepares trainees to elicit patient goals, create individualized care plans, and deliver holistic care that honors patient values.