A Diary of Familiarity: A Qualitative Exploration of Clinicians' Experiences of Familiarity and Serious Illness Decision-making in A Rural State.

Effective communication is critical for quality palliative and end-of-life care. However, rural-practicing clinicians may experience difficulty initiating these conversations due to close personal relationships they may have with their patients. Reflexive thematic analysis guided our interpretation of interviews from 10 health care clinicians practicing in a rural state. Unlocking the diary is our overarching theme, where familiarity served as a key to unlocking personal and professional views of patients' diary entries. These diary entries (themes) are: emotional toll, bringing the pages together, and honesty. Curricula for prelicensure/postlicensure clinicians should include how familiarity can strengthen patient-clinician communication in palliative and end-of-life decision-making.