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Medicine Grand Rounds - Beyond Advance Directives: The Serious Illness Care Program at Dartmouth-Hitchcock Medical Center

The presenters at this presentation show their passion for teaching communication skills that enhance compassion between patients, families and providers in situations of acute or chronic serious illness. They identify the gaps in advance care planning documentation and planning, and demonstrate a validated framework for “more, earlier, better and visible” communication and record retrieval.

Activity Details
Start Date: August 31, 2018
End Date: August 31, 2020

You may claim CME credit for successful completion of this online course. In order to claim credit, you must follow these steps:

  1. Register for the learning activity by creating an account or logging in to your account.
  2. Click Continue to navigate to the Activity Material tab. Click View Presentation to view the recording.
  3. Return to this Activity page.
  4. Click Continue to navigate to the Evaluation tab; then click the Launch button to start the evaluation.
  5. Complete and Submit the evaluation and attestation form.

When the evaluation is submitted, you will be awarded credit. You may access your transcript for verification of participation at any time via Your Account. Need help? Visit the Support Page, send an Email, or call the Center for Learning and Professional Development at (603) 653-1234, Option 1.


  • Amelia M. Cullinan, MD
    Assistant Professor of Medicine
    Geisel School of Medicine at Dartmouth
    Dartmouth-Hitchcock Medical Center

    Dr. Amelia Cullinan is the Director of Outpatient Palliative Care Services, which provides longitudinal care to patients diagnosed with serious illnesses, offering expert symptom management, psychosocial support, and assistance with medical decision-making and advance care planning. Dr. Cullinan trained in Internal Medicine-Primary Care at St. Vincent’s Hospital and Medical Center in New York City, and completed a fellowship in the Harvard Palliative Medicine Program. Dr. Cullinan’s non-clinical passions are education and advance care planning, and she combines these in her work as a regional and national leader in teaching primary Palliative Care communication skills through dissemination of the Serious Illness Conversation Guide; she and Max Vergo, MD direct the Serious Illness Care Program at DHMC. In addition, she is employed by Dartmouth-Hitchcock’s Division of Population Health, where she leads efforts to build advance care planning tools into the system’s electronic medical record.
  • Max T. Vergo, MD, FAAHPM
    Assistant Professor of Medicine
    Geisel School of Medicine at Dartmouth
    Dartmouth-Hitchcock Medical Center

    Dr. Max Vergo is the Hospice and Palliative Medicine fellowship program director, and the director of education in the section of Palliative Medicine. He earned his MD at Tufts University School of Medicine, trained as an internist at Massachusetts General Hospital, trained in hospice and palliative medicine at the Harvard fellowship, and in medical oncology at Northwestern University in Chicago. He helped develop and implement innovative educational platforms to teach specialty and primary palliative care to fellows, residents, medical students, physician assistants, advanced practice nurses, and pharmacists. One of his passions is to develop efficient and effective ways to teach serious illness conversations to other health care providers. He has trained with national leaders in VitalTalk practice, a method for giving learner-oriented and directed communication feedback to assist in communication practice change and culture shift. His research interests include optimal communication education and using legacy and life review with patients to decrease grief and make medical decision making more goal-concordant.
Learning Outcome

At the conclusion of this learning activity, participants will be able to identify gaps in our current systems for Advance Care Planning, describe the results of national and local implementation efforts in serious illness conversation and recognize future directions of the Serious Illness Care program at DHMC.


Dartmouth-Hitchcock is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Dartmouth-Hitchcock designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Requirements for Successful Completion

In order to receive credit for this Continuing Medical Education (CME) activity, you must:

  • View the entire presentation
  • Complete the online Attestation of Attendance & Evaluation Form (you must register to access).

In accordance with the disclosure policy of Dartmouth-Hitchcock/Geisel School of Medicine at Dartmouth as well as standards set forth by the Accreditation Council on Continuing Medical Education and the Nursing Continuing Education Council standards set forth by the American Nurses Credentialing Center Commission on Accreditation, continuing medical education and nursing education activity director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content have been asked to disclose any financial relationship* they have to a commercial interest (any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on patients). Such disclosure is not intended to suggest or condone bias in any presentation, but is elicited to provide participants with information that might be of potential importance to their evaluation of a given activity.

The following Activity Physician Director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content for Beyond Advance Directives: The Serious Illness Care Program at Dartmouth-Hitchcock Medical Center (Medicine Grand Rounds) have reported the following financial interest or relationship* with various companies/organizations. The Activity Director and Planning Committee member roles were resolved by altering the individual’s control over content about the products or services of the commercial interest by the Associate Dean for CME and the Department of Medicine Chair. All potential conflict(s) were resolved.

* Kelly Kieffer, MD ~ her spouse is a consultant for OcculoBio. 

* Richard I. Rothstein, MD ~ has research support from Baranova (research grant to Dartmouth-Hitchcock Medical Center) and has other financial interest from Takeda. 

Other planning committee member(s), speaker(s), activity director(s), author(s) or anyone in a position to control the content for this program report no financial interest or relationship* with any company(ies) or organizations whose product may be germane to the content of their presentations.

*A “financial interest or relationship" refers to an equity position, receipt of royalties, consultantship, funding by a research grant, receiving honoraria for educational services elsewhere, or to any other relationship to a company that provides sufficient reason for disclosure, in keeping with the spirit of the stated policy.

Provider Contact Information

Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
Dartmouth-Hitchcock Medical Center

Type:     Internet Activity (Enduring Material)
47 Registered Users