Finding the right words: preparing medical students for communication on the wish for hastened death - medical students’ perceptions of drama-based and online communication training

Abstract Background In Germany, assisted suicide is legal, placing ethical and communicative demands on physicians. Medical students (MS), however, often feel inadequately prepared for such conversations. This study explores how MS perceive two teaching formats designed to support communication skills in such a context. Methods As part of the Erasmus+-funded ELPIS project (E-Learning on Palliative Care for International Students), in 2023 a drama seminar (DS) and an online tool (OT) were offered to MS of the RWTH Aachen University on a voluntary basis to support communication skills training. For evaluation, qualitative interviews were conducted with 15 MS from RWTH Aachen University. Semi-structured interviews were transcribed and analysed through qualitative content analysis, applying both inductive and deductive approaches. Results All 15 MS viewed the DS as emotionally intense and immersive, with empathic engagement, self-reflection, and opportunities to practise communication skills emerging as central aspects of the experience. Several MS, however, reported emotional overload when performing in front of peers. The OT was appreciated for its flexibility, structured design, and emotionally safe environment, particularly by those with limited prior experience. Its limitations included reduced realism, lack of non-verbal interaction, and a diminished sense of authenticity. MS suggested a hybrid learning approach, using the OT as a preparatory phase before the DS. The interviews revealed a lack of knowledge regarding the legal framework of assisted suicide, reinforcing the need to integrate legal and ethical education into the medical curriculum. Conclusion The findings suggest that the two formats offer different strengths in preparing MS for challenging end-of-life conversations, with the interview findings further indicating that a blended learning format may reduce emotional barriers and support a stepwise approach to communication training. Integrating communication training alongside ethical and legal education represents an important step towards strengthening palliative care curricula.