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CONTEXT Conflict is frequently reported by both clinicians and surrogate decision-makers for adult patients in intensive care units (ICUs). Since religious clinicians view religion as an important dimension of end-of-life care, we hypothesized that religious critical care attendings (intensivists) would be more comfortable and perceive less conflict when discussing a patient's critical illness with a religious surrogate (12). OBJECTIVES To assess if religious intensivists are more or less likely to perceive conflict during a simulated family meeting than secular colleagues. METHODS Intensivists were recruited to participate in a standardized, simulated family meeting with an actor portraying a family member of a critically ill patient. Intensivists provided demographic information including their current religion and the importance of religion in their lives. After the simulation, intensivists rated the amount of conflict they perceived during the simulation. The association between intensivist self-reported religiosity and perceived conflict was estimated using both univariate analysis and multivariable logistic regression. RESULTS Among 112 participating intensivists, 43 (38%) perceived conflict during the simulation. Among intensivists who perceived conflict, 49% were religious, and among those who did not perceive conflict, 35% were religious. After adjusting for physician race, gender, years in practice, ICU weeks worked per year and actor, physician religiosity was associated with greater odds of perceiving conflict during the simulated family meeting (Adjusted Prevalence Ratio = 2.77, [95% CI 1.12 - 7.16], P=0.03). CONCLUSIONS Religious intensivists were more likely to perceive conflict during a simulated family meeting.