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Introduction Interpersonal and communication skills are core competencies for neonatal fellowship trainees, yet formal communication training rarely exists.

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Presentation on theme: "Introduction Interpersonal and communication skills are core competencies for neonatal fellowship trainees, yet formal communication training rarely exists."— Presentation transcript:

1 Introduction Interpersonal and communication skills are core competencies for neonatal fellowship trainees, yet formal communication training rarely exists in most neonatal fellowship programs. Currently, neonatology fellows and other medical trainees learn to communicate difficult information to families by trial and error, as well as observation and imitation of role models. Benefits of Simulation in Medical Education: Unlimited exposure to high-risk clinical events in which trainees need practice Enables direct observation and assessment of skills in a safe environment Immediate feedback and learning via debriefing Great for adult learners who learn best by “doing” Simulation is an innovative educational tool that offers an opportunity for communication training using objective monitoring and immediate feedback for trainees in a controlled setting. The purpose of this study is to assess the efficacy of a novel simulation-based curriculum in improving neonatal fellow comfort and proficiency in carrying out challenging conversations with patient families. Improving Family-Centered Care Using Simulation-Based Communication Training for Neonatology Fellows Nada Ghoneim, MD 1 (PGY-6), Vedanta Dariya, MBBS 1, Leslie L Harris, MD 1, Ernest D Fruge, PhD 2, Karen E Johnson, MD 1 and Jennifer L Arnold, MD 1 1 Neonatology, 2 Pediatrics, Texas Children's Hospital & Baylor College of Medicine, Houston, Texas 77030, United States Results Figure 1 shows results of the Self-Assessment survey for each question and at each of the three time points. It shows that there was improvement in 5 out of the 8 questions surveyed immediately after training compared to pre-training. In terms of follow-up, the only question in which this improvement was not retained was related to fellows’ comfort in making a plan that balances medical needs with family wishes. Overall, self-assessment scores as well as content test scores immediately after training improved compared to pre-training, and this improvement was retained after 3 months (Figures 2 & 3). Abstract Effective communication with families in the Neonatal ICU is critical in reducing the short- and long-term trauma families face in dealing with their loved one’s illness. Additionally, communication skills are an important component of neonatal fellowship training. We hypothesized that simulation-based training, combined with didactic teaching, would improve the proficiency and comfort of NICU fellows in carrying out difficult conversations with patient families. The aim of the study was to assess objective performance, content mastery, and self-perceived ability to communicate in challenging situations with standardized patients before, immediately after, and 3 months after a simulation-based training course. Preliminary results show that self-assessment scores as well as content test scores immediately after training improved compared to pre-training, and this improvement was retained after 3 months. We conclude that this novel simulation-based curriculum is a useful tool that may improve fellows’ comfort and proficiency in carrying out challenging conversations with patient families. Description of intervention/study Subjects: Baylor Neonatology Fellows for The intervention, which included a training course and a follow-up session, was implemented twice: first, in the fall for the first year fellows, and second, in the spring for the second- and third-year fellows. Components of the Intervention: Training Course Curriculum: Didactic sessions: SPIKES method of delivery of bad news & disclosure of medical errors Simulation Training: 3 scenarios with standardized patients acting as parents of a NICU patient, video-recorded for review, with debriefing after each case Example scenarios: Trisomy13 diagnosis, hypoxic ischemic encephalopathy, Grade IV intraventricular hemorrhage Follow-up Session: One scenario with standardized patient, video-recorded, followed by immediate debriefing Evaluations: Prior to course, after course, and after 3-month follow-up session: Content test – 12 multiple choice questions testing content taught in didactics and debriefing, related to SPIKES protocol and medical error disclosure Self-assessment survey – evaluation of self-perceived effectiveness in leading difficult conversations with families Conclusions Simulation-based communication training in combination with didactic teaching for neonatal fellows in our institution provided improved self-perceived proficiency and knowledge of evidence- based communication principles and protocols for delivery of bad news. Ongoing analysis includes evaluation of objective fellow performance using validated checklists of the video-recorded simulation sessions by blinded raters. In the future, we hope to broaden this training to other departments or institutions, as well as to other healthcare practitioners. References 1.Melnyk BM, Alpert-Gillis L, Feinstein NF, Crean HF, Johnson J, Fairbanks E et al. Creating opportunities for parent empowerment: program effects on the mental health/coping outcomes of critically ill young children and their mothers. Pediatrics 2004; 113: e597-e Henley A, Schott J. The death of a baby before, during or shortly after birth: good practice from the parents’ perspective. Semin Fetal Neonatal Med 2008; 13: Boss, RD, Hutton N, Donohue PK, Arnold RM. Neonatologist training to guide family decision making for critically ill infants. Arch Pediatr Adolesc Med 2009; 163: Szmuilowicz E, el-Jawahri A, Chiappetta L, Kamdar M, Block S. Improving residents’ end-of-life communication skills with a short retreat: A randomized controlled trial. J Palliat Med 2010; 13: Boss RD, Urban A, Barnett MD, Arnold RM. Neonatal Critical Care Communication (NC3): training NICU physicians and nurse practitioners. J Perinatol 2013 Feb 28. Texas Pediatric Society Electronic Poster Contest Jul 2013 AugSepOctNovDecJanFebMarAprMayJun 2014 Course #1 1 st year fellows (n=6) Follow-up #1Course #2 2 nd /3 rd year fellows (n=9) Follow-up #2 SPIKES Set up interview Perception: assess parent/patient’s perception Invitation: obtain permission Knowledge: inform patient Emotions: recognize and respond to parent/patient’s emotion Summarize and explain strategy Figure 1 Figure 3 Figure 2


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