How did the idea for training healthcare professionals in communication about dying come about?
Steffen Eychmüller: Death is unfortunately a common reality in hospitals and nursing homes. Yet, we often struggle to discuss someone’s approaching end with them. That feeling of helplessness can be overwhelming. At the same time, many relatives experience sadness and anger because they weren’t informed in time—a frequent complaint in hospital ombudsman offices for years. We wanted to improve this.
Sissel Guttormsen: From the very beginning, our goal was clear: to support healthcare professionals in having these difficult conversations. This motivated us to create the “Talking about dying” module, which we developed and scientifically evaluated with funding from the Swiss Cancer Research foundation. We now offer this on our learning platform, DocCom. The module combines theory with videos showing conversations between experienced professionals and actors portraying terminally ill patients and their families. Ideally, this is followed by communication training, allowing learners to practice in a safe environment before applying these skills with real patients. We’ve had success with this format in other communication topics, like discussing medical errors.
Do those who complete the training find it easier to talk about dying?
Guttormsen: Absolutely. Our data clearly shows that communication is a logical process—and therefore learnable. We broke down this process into manageable steps in the module, enabling learners to internalize the approach. Once mastered, they can focus more fully on their patients.
Eychmüller: Still, talking about dying remains a special challenge. Medical training focuses on preserving life, so it’s hard when that goal can no longer be achieved—even though dying is a natural part of life. In these moments, having a framework to guide you and the ability to discuss challenges within the team is invaluable.
You found the training reduced fear more in medical students than in nursing professionals. Why do you think that is?
Guttormsen: Our controlled study showed strong learning effects, especially among medical students. Most had never spoken with someone about dying and had a significant knowledge gap—which they successfully closed. Nursing professionals had a smaller learning effect because they generally had more experience to begin with.
Eychmüller: We also found that nurses often don’t see talking about dying as their primary responsibility, viewing it more as the doctors’ task. This underscores the importance of team communication: deciding together who knows the patient best and who feels emotionally prepared to lead such conversations.
How do you look back on your collaboration?
Guttormsen: It was excellent, built on mutual trust. For me, it exemplified how interdisciplinary projects should work: we shared the same goal and complemented each other’s expertise perfectly.
Eychmüller: The back-and-forth between clinical work and teaching is, in my opinion, a model for the future. I’m grateful for the funding that allowed us to focus on this often overlooked topic. Communication still plays a subordinate role in healthcare, but our findings show there is an evidence-based approach—and quality standards—for talking about dying. We hope this will elevate communication as a recognized medical intervention. Good communication is something we all want to experience, but professionals must be able to train their skills. Practice makes perfect.
But are professionals actually willing to practice?
Guttormsen: Students appreciate our communication courses because they learn something essential. Another key factor is self-efficacy: if I don’t believe I can talk about dying, I’ll avoid it. But realizing through training that I can handle these conversations makes them less burdensome.
Eychmüller: Exactly. Just as knowing how to swim gives you the confidence to jump in, learning how to talk about death empowers people to face these conversations with courage and care.