Monroe Carrell Jr. Children’s Hospital at Vanderbilt
Nashville, TN
Program Director: Geoffrey Fleming, MD
Type of Program: Pediatric Critical Care Medicine
Abstract Authors: Erin R. Powell, MD, and Jessica Turnbull, MD, MA
Good communication is an essential skill for all physicians. Poor communication was cited as one of the top root causes of all sentinel events by the Joint Commission from 2004-2014. Fellows in pediatric subspecialties are required by the ACGME Core Competencies and the Pediatric Milestones Project to achieve competency in communication skills. While most fellowship programs focus on traditional skills such as medical knowledge and procedural skills, little training exists on teaching communication. There is a growing body of literature that demonstrates curricula can improve communication skills. Many of these studies evaluate trainee confidence and perception of a particular curriculum. However, few studies have been performed to determine if implementation of such a curriculum improves trainee performance or family satisfaction. Additionally, few studies have been performed to evaluate communication curricula in pediatrics. The aim of this project is to design and implement a curriculum to improve communication skills among pediatric critical care fellows. By improving communication skills, we hope to improve fellow confidence and family satisfaction.
This is a prospective study involving the pediatric critical care medicine (intervention group) and neonatal intensive care fellows (control group) from 2015-2016 at MCJCHV. The intervention group will participate in a new longitudinal curriculum designed to teach communication skills in the care of critically ill pediatric patients. The curriculum is divided into 6 didactic sessions and 3 practice simulation sessions with standardized family members in which fellows can practice using the skills in a safe environment. The curriculum covers topics such as basic communication skills, emotionally challenging conversations, communicating across cultures, end-of-life conversations, leading family/team meetings, and negotiating professional disagreements. After each session, fellows are asked to practice and reflect on the skills taught in subsequent clinical encounters. Please see supporting documents that include an annotated presentation and a simulation session as examples of the curriculum. For objective analysis of change in communication skills, all participants will complete pre- and post-curriculum standardized family member simulations and be evaluated using a communication performance evaluation checklist. Additionally, pre- and post-curriculum surveys assessing participant confidence in communication skills will be used for comparative analysis of subjective improvement in both the intervention and control groups. Caregivers of patients in the pediatric critical care unit will also be surveyed via a standardized communication evaluation tool before and after implementation of the curriculum regarding their satisfaction with communication with the fellow caring for their child during hospitalization.
