It was a rainy night a few weeks before Coach K’s final home game when I decided to apply to Bass Connections.

As I sat in the study tent waiting for the next tent check, I began to peruse Duke’s websites for anything and everything that I could get involved in as my first year was coming to an end. Getting involved with research at Duke was one of the very first goals I set for myself before coming to college, and as I stumbled across Bass Connections, I knew it was an opportunity that I could not overlook. Science research was one of my favorite classes in high school, so I was drawn to the prospect of participating in interdisciplinary, team-based research in a university setting. I filled out the application that same night, not knowing that it would greatly impact my experience as Duke student.

As a rising junior now, I’ve just finished my first year on the Roadmap for Evaluating Goals in Advanced Illness Navigation (REGAIN) team. This team focuses on goals of care conversations and their role in ensuring effective, patient-centered communication in palliative care settings. Before joining this team, I was unfamiliar with the field of palliative care. Now that I understand how it can impact a patient’s clinical experience, it has changed my view on what it means to be a healthcare provider.

Palliative care is a specialty field focusing on symptom management and quality of life in cases of serious illness. With patient values and goals at the forefront of this field, constant communication between patients and their healthcare providers is essential to maximize the success of palliative care. To further investigate this field and ways to optimize care, my fellow REGAIN team members and I sought to learn more about “goals of care” conversations. These conversations revolve around patient preferences pertaining to their current illness, quality of life and end of life, and are integral to advanced care planning. 

With my individual mentor, Jessica Ma, I have conducted qualitative research to evaluate the emotional context from transcripts of goals of care conversations. This emotional context goes beyond emotions like sadness, worry or distress, and frames patient feelings with underlying themes such as acceptance or “being a burden.” My past research experience had not touched upon this kind of interdisciplinary, healthcare-oriented work, and although it was daunting, I was eager to delve into this new type of research and apply what I learned to my own career outlooks. 

Through this project, I have learned that goals of care conversations are complex and that responding with intent and empathy can be transformative to providing patients with a safe space to express their thoughts and wishes. Although I have not encountered this in real-time yet, my work with Dr. Ma has deepened my perspective of what it means to understand, respect and support patients and their experiences. This research is ongoing, and I am grateful to have the opportunity to share my research through an upcoming academic publication and engage with the project from start to finish, continuing to articulate what I have learned.

As a team, my fellow REGAIN members and I also got to hear about palliative care from providers themselves. We conducted a series of interviews with palliative care providers from the Duke University Health System to gain a better understanding of what palliative care means in practice. Before joining this Bass Connections team, my exposure to practicing doctors in any field had been limited.  Hearing about the challenges within and outcomes from palliative care from the people who know this field best was an enlightening experience, especially as it supplemented what I had taken away from my individual research. We also consulted with our team leader, David Casarett, who was able to speak candidly in response to our many questions. 

As a proponent of collaborative learning and discussion, Dr. Casarett challenged us to think in a way that I hadn’t before. My teammates and I used Mural, a design thinking teamwork platform, to collect our thoughts, reflect on overarching themes from the interviews and identify barriers to having goals of care conversations based on the perspectives of these providers. Although we were all skeptical about the usefulness of this platform in the beginning, we slowly became fans of Mural, as it allowed us to integrate our thoughts and digitally collaborate in a creative and efficient way. After weeks of working on this project, we were able to create and present a poster as a mosaic of our individual insights and a culmination of our findings as a team.

Ultimately, my experience on my Bass Connections team has been one of the highlights of my academic career at Duke thus far. The interdisciplinary and collaborative nature of the program has allowed me to step out of my comfort zone to explore uncharted avenues of research while expanding my own goals as a researcher and aspiring healthcare provider, and I am excited to continue learning with the REGAIN team in the future. 

My research — both with my mentor and my team — has enriched my understanding of the role of healthcare providers in a patient’s clinical experience. Beyond just treating illnesses, healthcare providers have the capacity to transform a patient’s health trajectory by simply ensuring that they are truly heard. Although I am unsure of where my professional journey will take me, I will be able to reflect on my work with this team and what I have learned about the importance of goals of care conversations as I strive to equip patients with the necessary resources to communicate their values and goals. 

May 2023