Simulation-Based Palliative Care Communication for Pediatric Critical Care Fellows
Title
Simulation-Based Palliative Care Communication for Pediatric Critical Care Fellows
Creator
Brock K E; Tracewski M; Allen K E; Klick J; Petrillo T; Hebbar K B
Identifier
Publisher
The American Journal of Hospice & Palliative Care
Date
2019
Subject
palliative care; communication; simulation; pediatric critical care; breaking bad news
Description
BACKGROUND: Pediatric palliative care (PPC) education is lacking in pediatric critical care medicine (PCCM) fellowships, despite the desire of many program directors and fellows to expand difficult conversation training. Simulation-based training is an experiential method for practicing challenging communication skills such as breaking bad news, disclosing medical errors, navigating goals of care, and supporting medical decision-making. METHODS: We describe a simulation-based PPC communication series for PCCM fellows, including presimulation session, simulation session, debriefing, and evaluation methods. From 2011 to 2017, 28 PCCM fellows participated in a biannual half-day simulation session. Each session included 3 scenarios (allowing for participation in up to 18 scenarios over 3 years). Standardized patients portrayed the child's mother. PCCM and interprofessional PPC faculty cofacilitated, evaluated, and debriefed the fellows after each scenario. Fellows were evaluated in 4 communication categories (general skills, breaking bad news, goals of care, and resuscitation) using a 3-point scale. A retrospective descriptive analysis was conducted. RESULTS: One hundred sixteen evaluations were completed for 18 PCCM fellows. Median scores for general communication items, breaking bad news, and goals of care ranged from 2.0 to 3.0 (interquartile range [IQR]: 0-1) with scores for resuscitation lower at 1.0 (IQR: 1.5-2). DISCUSSION: This experiential simulation-based PPC communication curriculum taught PCCM fellows valuable palliative communication techniques although revealed growth opportunities within more complex communication tasks. The preparation, methods, and lessons learned for an effective palliative simulation curriculum can be expanded upon by other pediatric training programs, and a more rigorous research program should be added to educational series.
Citation List Month
June 2019 List
URL Address
Collection
Citation
Brock K E; Tracewski M; Allen K E; Klick J; Petrillo T; Hebbar K B, “Simulation-Based Palliative Care Communication for Pediatric Critical Care Fellows,” Pediatric Palliative Care Library, accessed April 25, 2024, https://pedpalascnetlibrary.omeka.net/items/show/16170.