Á Demonstrate how to give unwanted news Á Demonstrate how to conduct a discussion with thè`a ngry patient'' Á Demonstrate how to lead a discussion to establish goals/patient preferences, including DNR orders and changes in treatment from curative to palliative approach DESCRIPTION OF PROGRAM/INTERVENTION: All interns attend 2 required afternoon retreats (8 hours total contact time). The first retreat focuses on basic communication skills such as empathy and attentive listening and breaking bad news. The second retreat addresses goalsetting and DNR decisions with the terminally ill patient and death pronouncement. We used a variety of formats: large group role-plays and debriefing discussions, brief handouts, pre-tests and videotaped, standardized patient stations with immediate, individual feedback from faculty observers. FINDINGS TO DATE: 20 interns completed the first retreat training and 22 completed the second. Intern pre/post self-assessment shows significant improvement in degree of competency and knowledge. On a scale of 1 to 4 (4 being most competent/most knowledgeable), interns report greater knowledge in discussing goal setting (2.5 to 3.5; p < 0.05) and discussing DNR orders (2.4 to 3.5; p < 0.05) and self-perceived increased competence in giving bad news (3.1 to 3.7; p < 0.05 ) and death pronouncement procedures (2.9 to 3.7; p < 0.05). Interns praised the retreat for the open interaction with faculty experts, the opportunity to role play patient care situations and the exposure to topics not previously discussed in medical training. A few mentioned distaste for being videotaped. KEY LESSONS LEARNED: A retreat format, using large group role-plays and individual standardized patient encounters with feedback, is a useful method of teaching and evaluating important end-of-life communication skills. Interns who needed extra help in communication and interpersonal skills were identified and individually reviewed these skills with faculty mentors.