Can better training get doctors to talk about what matters most to dying veterans?
NCT ID NCT05001009
First seen Sep 16, 2026 · Last updated Sep 17, 2026 · Updated 1 time
Summary
Researchers are testing two ways to train VA primary care clinicians to hold goals of care conversations with veterans who have serious illnesses such as cancer, heart failure, or dementia. One approach gives clinicians written materials and online training. The other adds team facilitation and more intensive support. The study tracks whether these conversations get documented in medical records, using surveys and interviews with providers, patients, and caregivers.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- clinician training programs to encourage goals of care conversations
- What this could lead to
- If one training approach works better, VA clinics could adopt it to help more veterans discuss and document their treatment goals earlier, so care better matches what matters to them.
- What could go wrong
- Training clinicians does not guarantee they will hold these conversations, and busy clinics may struggle to fit them in. The study measures whether notes get written, not whether veterans feel their care improved.
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Study facts
What this study's own registry entry says, in plain language.
- Phase
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Not a phased trial
Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.
- Participants
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2,859 people
The number who actually took part.
- Started
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Sep 2022
- Finished
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Sep 2025
- Lead sponsor
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A government agency
The lead sponsor is a US federal agency other than the NIH.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 years and older
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: CLINICIANS VA primary care advance practice clinicians (MDs, APRNs, PAs) at one of the three study sites able to complete goals of care conversation notes and orders. Advance practice clinicians will be eligible for randomization if they have at least 15 eligible patients without goals of care conversation notes at the start of stage 1 (to allow participating clinicians ample opportunities to write notes) and have written fewer than 4 goals of care conversation notes in the previous 6 months (to select clinicians who need improvement), and can potentially receive the planned implementation strategies, i.e., clinicians who regularly attend the Patient Aligned Care Team (PACT) team meetings. PATIENTS * Veteran enrolled in VHA health care in one of the three study sites who is a current patient of one of the eligible primary care clinicians * Diagnosis of cancer, heart failure, interstitial lung disease, chronic obstructive pulmonary disease, end-stage renal disease, end-stage liver disease, and dementia * Care Assessment Need score of \> or equal to 90 using the one-year combined hospitalization/mortality variable Exclusion Criteria: PATIENTS * Prisoner * Pregnant * under 18 years of age.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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Rocky Mountain Regional VA Medical Center, Aurora, CO
Aurora, Colorado, 80045-7211, United States
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VA Greater Los Angeles Healthcare System, West Los Angeles, CA
West Los Angeles, California, 90073-1003, United States
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VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, California, 94304-1207, United States
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