REGAIN: Roadmap for Evaluating Goals in Advanced Illness Navigation (2021-2022)

Patients who are facing a serious illness must make numerous complex healthcare decisions that will determine what treatment they receive, what their quality of life will be and how long they will survive. Too often, patients and their families must make these decisions without adequate communication about their hopes, fears, values and goals. As the population ages, and as healthcare decisions become more complicated, it is increasingly important to ensure that all patients have access to thoughtful, open and accurate communication about their goals.

REGAIN is a collaboration between Duke Health (including the School of Medicine and the School of Nursing) and Duke University. The aim is to develop and implement a roadmap for goals of care conversations for Duke Health patients with serious illnesses. Led by the Duke Center for Palliative Care, and supported by the health system and academic partners, REGAIN will be Duke Health’s strategy for ensuring that all patients have access to open accurate and empathetic communication about their goals for care.

In 2021-2022, this project team investigated patient-provider communication and communication between patients and their loved ones. One subteam investigated the experience of having a loved one in the ICU before and during the COVID-19 pandemic, and how healthcare providers can act as cultural guests, supporting patients and their loved ones while in the ICU by enhancing trust and communication. They identified four key pillars that foster healthcare team members to develop a cultural guest mindset: genuine connection, building trust, establishing expectations and respecting culture.

Another subteam examined patients’ affective expressions during cancer-related conversations with their partners as a function of cancer stage and gender using observational methods. Results suggest that male-identifying patients may be more likely to suppress their emotional expressions, whereas female-identifying patients were more likely to show vulnerability and distress.

Learn more about this project team by viewing the team's video.


Fall 2021 – Spring 2022 

Team Outputs

Improving Communication for Patients with Serious Illness (2022 Fortin Foundation Bass Connections Virtual Showcase)

Healthcare Providers as Cultural Guests of Patients and Their Loved Ones During the COVID-19 Pandemic: Establishing Trust in the ICU (poster by Haripriya Dukkipati, Amie Koch, Remi Misiewicz, Kimberlee Grier, Bonnie Hepler, Christopher Cox and Sharron Docherty, presented at Fortin Foundation Bass Connections Showcase, Duke University, April 13, 2022)

Objectively Measured Affective Expression in Cancer Patients by Cancer Stage and Gender (poster by Evan Liu, Karena Leo, Katherine Ramos, Laura Porter, Shelby Langer and Brian Baucom, presented at Fortin Foundation Bass Connections Showcase, Duke University, April 13, 2022)


Erica Langan

This Team in the News

The Arts Advantage: Nurturing the Human Experience Through Theater Studies

Meet the Members of the 2021-2022 Bass Connections Student Advisory Council

See related teams, REGAIN: Roadmap for Evaluating Goals in Advanced Illness Navigation (2022-2023) and REGAIN: Roadmap for Evaluating Goals in Advanced Illness Navigation (2020-2021).


Team Leaders

  • David Casarett, School of Medicine-Medicine: General Internal Medicine
  • Dalton Hughes, Medicine–Neurobiology–Ph.D. Student

/undergraduate Team Members

  • Madison Canfora, Neuroscience (AB)
  • Samarth Menta, Public Policy Studies (AB)
  • Evan Liu, Biology (BS)
  • Daniel Lee, Biology (BS)
  • Erica Langan, Biology (BS)
  • Lauren Howard, Neuroscience (AB)
  • Avery Garmon, Psychology (BS)
  • Haripriya Dukkipati, Biology (BS)
  • Nikki Daniels, English (AB)
  • Alice Chun, Public Policy Studies (AB)
  • Simran Bansal, Program II (BS)

/yfaculty/staff Team Members

  • Arif Kamal, School of Medicine-Medicine: Medical Oncology
  • Brystana Kaufman, Fuqua School of Business-Health Sector Management Program
  • Thomas Leblanc, School of Medicine-Medicine: Hematology
  • Monica Lemmon, School of Medicine-Pediatrics: Neurology
  • Laura Porter, School of Medicine-Psychiatry and Behavioral Sciences
  • Katherine Ramos, School of Medicine-Psychiatry: Behavioral Medicine
  • Joseph Winger, School of Medicine-Psychiatry and Behavioral Sciences