Tutorial: Using an AI Tool to Prepare for a Goals of Care Conversation

Goals of care conversations cannot be scripted. They are responsive, human, and carried by the relationship between you and your patient. No tool can prepare you for the exact way this patient will respond.

What a tool can do is help you think through the conversation before you walk in. To consider what questions are coming. To find plain-language wording for the concepts you know are hard to hear. To have a structure in your mind so that when the conversation takes an unexpected turn, you can find your way back.

This tutorial shows you how.

The scenario: you are about to see a patient in his late sixties. He has advanced lung cancer and has been through two lines of treatment without sustained benefit. His disease is progressing. His adult daughter has been at every recent appointment and has been asking what other options exist. The patient himself has not yet been told directly that no further systemic treatment is planned.

Step 1: Open the tool and set the context clearly

Open claude.ai or chat.openai.com. Start a fresh conversation. Begin by telling the tool exactly what you need:

I am an oncologist. I am preparing for a goals of care conversation. 
I want help thinking through the conversation before I go in. I am not 
asking for a script. I need: a list of likely questions from the patient 
and family, a suggested structure for the conversation, and plain-language 
wording for explaining what a palliative care approach involves.

Do not include any clinical recommendations. Do not include any reference 
to prognosis or timelines.

Wait for the tool to acknowledge.

Step 2: Provide the anonymised clinical context

Clinical context:
- Patient: man, late sixties, advanced lung cancer
- Treatment history: two prior lines of systemic treatment, 
  disease progressing on second line
- Family: adult daughter attends all appointments, has been asking 
  directly about further treatment options
- What has been said: patient is aware disease is not curable. 
  He has not been directly told that no further systemic treatment 
  is being planned.
- Appointment length: 30 minutes

Step 3: Read the list of likely questions

The tool will return a structured list of questions. Here is an example:

Understanding the situation

• Is there nothing else you can try?
• What does "the disease is progressing" actually mean?
• Am I getting worse?

Questions from the daughter

• Are you saying there is nothing left to do?
• How long does he have?
• Why are we stopping treatment now?

Practical concerns

• Will he be in pain?
• Can he stay at home?
• What happens next — who looks after him now?

Questions about palliative care

• Is this giving up?
• What does palliative care actually involve?
• Will he still be seen by oncology?

Read through this list. Most questions you expected. Some you may not have prepared for. The daughter's question — "Why are we stopping treatment now?" — may arrive in a form that feels like an accusation. Thinking through your response now means you will not be caught off-guard.

Notice that "How long does he have?" appears on this list. The tool correctly includes it as a likely question. This is a question you will need to decide in advance how to approach — not because the tool has told you what to say, but because you have now thought about it before you walk in.

Step 4: Review the suggested conversation structure

The tool will suggest a structure. An example:

0–5 minutes: Ground the conversation. Acknowledge what you know has been a difficult period. Ask how he has been feeling. Give him a moment before the clinical content.

5–12 minutes: Be direct and clear about the clinical picture. Use plain language. Pause after the key statement. Allow silence. Do not fill it immediately.

12–22 minutes: Explain what comes next. What palliative care is, what it focuses on, what happens to his oncology relationship. Answer his questions. Resist the urge to cover everything — he will not retain it all today.

22–28 minutes: Address the daughter. She may have different questions. She may have received this news differently. Acknowledge her as well as the patient.

28–30 minutes: Close with what happens next. Who makes contact. What the patient should do if anything changes before then. Confirm who to call.

This is a framework, not a script. You will adapt it in the room. But having thought through the phases means you are less likely to rush through the difficult middle section or arrive at the end of the appointment having missed something important.

Step 5: Ask for plain-language wording for the hardest part

The explanation of what palliative care means — and what it does not mean — is often the hardest part of this conversation. Ask the tool to draft language for it:

Draft a plain-language explanation of what a palliative care approach 
involves — what it focuses on and what it does not mean — that I could 
use as the basis for how I explain it verbally to this patient. 

It must not imply abandonment or giving up. It should not use the word 
"terminal". Maximum 100 words.

The tool will produce something like this:

Moving to a palliative care approach means that our focus shifts to your comfort and quality of life. It means making sure that any pain or symptoms you experience are managed as well as possible. It means you have the right team around you, at home or in a hospice setting if that is what suits you best. It does not mean stopping care. It means the kind of care changes. Your oncology team remains involved.

Read this carefully. Would you say these words? Do they sound like you? If not, adjust: ask the tool to "make this sound less formal" or "rewrite this for someone who has always found medical language confusing."

This is the language you will personalise and make your own. The tool has given you a draft. The moment in the room is yours.

Step 6: Prepare for the daughter's likely response

Ask one more thing:

The patient's daughter has been asking about further treatment options 
and may feel that stopping systemic treatment is giving up. Suggest 
how to respond to her in a way that acknowledges her perspective 
without undermining the clinical decision or the patient's autonomy.

The tool will offer some framing. Read it. It will not be perfect — the tool does not know this daughter — but it will give you options to consider. You will choose your own words. But having thought about her response in advance means you are less likely to respond defensively when the moment comes.

Step 7: Set the preparation aside

The preparation is done. Close the tool or start a fresh conversation so it is not in front of you when you walk in.

The value of this process was the thinking, not the output. You have already asked yourself the hard questions. You know what the daughter is likely to say. You have found words for the palliative care explanation that sound like you. You have a structure to return to if the conversation goes somewhere unexpected.

Now you can be fully present with your patient.

What the tool does badly

It cannot tell you how this man will receive this news. It does not know what he most fears, what he most hopes for, or what he has been saying to his daughter in the car on the way to appointments. All of that requires you to be in the room, watching, listening, and adjusting in real time.

It also sometimes suggests opening lines that are slightly too polished — lines that sound like a consultation training exercise rather than a conversation between two people. Replace anything that sounds scripted. The preparation was for thinking, not for reading aloud.

What to try next

Apply this approach to other consultations you find consistently difficult — explaining a recurrence, consent for a procedure with significant side effects, or a conversation where a patient's expectations are significantly misaligned with the clinical picture. The method is the same. The specific preparation changes each time.

Remember: AI is a helpful assistant, not a clinician. You make the call.