•Describe a coaching intervention to improve resident physicians' palliative care skills.•Evaluate outcomes in resident preparedness, resident understanding of hospice and disposition options, and goals of care documentation resulting from palliative care coaching sessions. A previously developed coaching intervention increased resident physicians' preparedness in discussing palliative care (PC) topics and improved rates of documented goals of care (GOC) discussions. Based on resident feedback, we focused on prognostication and posthospital discharge options in PDSA cycle 2 of this quality improvement (QI) initiative. Evaluate whether short interactive PC coaching sessions increased residents' preparedness in discussing prognosis, knowledge of disposition options, and GOC discussion documentation with hospitalized patients. This prospective comparative QI initiative involved internal medical residents during their 4-week hospitalist rotation (three residents per cycle) at an urban medical center. A PC social worker led a brief didactic session about benefits of and requirements for home care, skilled nursing, and hospice. Two PC physicians led informal coaching sessions to build skills related to GOC conversations, prognostication, and any other PC topics residents raised. Both pre- and postrotation, residents completed surveys rating their preparedness on a five-point scale (from 1 “not well prepared” to 5 “very well prepared”) and a five-question multiple-choice test of disposition options. We measured GOC documentation in a patient population considered at-risk based on age, comorbid conditions, and frequent hospitalizations. We trained 30 residents over 10 months in thrice-weekly coaching sessions (average 18 minutes). Residents' preparedness increased most in evaluating appropriate hospice options (pre/post 3.2/4.0, change +0.8) and nonhospice disposition options (3.4/4.1, +0.7). Residents also reported increased confidence in communicating prognosis to patients/families (3.8/4.4, +0.6). Quiz scores did not differ pre- and post-rotation. Documented GOC discussions in at-risk patients increased from 21.1% prehospitalization to 87.4% by hospital discharge. Brief PC coaching sessions increased residents' preparedness in discussing PC topics including prognosis and disposition options, though an objective measure did not show increased knowledge of the latter. Coaching sessions increased the likelihood that residents facilitated GOC discussions with inpatients.