University of Maryland
Baltimore, MD
Program Director: Nirav Shah
Program Type: Pulmonary/Critical Care
Abstract Authors: Shah NG, Marr B, Netzer G, Tisherman SA
Description of Fellowship Program: The University of Maryland Pulmonary & Critical Care fellowship program provides comprehensive clinical training and a broad range of research opportunities in order to create a strong foundation for a career in Pulmonary & Critical Care Medicine. We pride ourselves on our collegiality with all of the Critical Care training programs at our institution and have worked collaboratively to create novel training tools that can benefit trainees from diverse backgrounds.
Abstract
Background
Communication is an essential skill set in critical care (cc) physicians’ professional development. Patients frequently report that clinical providers frequently pay insufficient attention to effectively explaining a diagnosis and treatment plans for their illnesses. While communication is important in the daily practice of critical care physicians, little training, practice, or feedback is provided to trainees. Data have shown both that communication can be taught but that mastery requires deliberate practice and feedback.
Methods
We developed a case-based simulation-based communications workshop for critical care fellows. In one case, the news of metastatic cancer was to be given to a patient and, in another, a family was to be informed of a loved one’s brain death. An interdisciplinary team consisting of a standardized patient or family member, a critical care nurse, either a social worker or chaplain, and a member of our organ procurement organization (only in the brain death simulation) worked collaboratively in each simulation. At the conclusion of each simulation, fellows received direct feedback from the entire interdisciplinary team, including the standardized patient, followed by one-on-one feedback with the faculty facilitator. Fellows were given a pre/post survey questionnaire assessing their comfort level with various aspects of communication. All healthcare participants also evaluated the workshop as a whole.
Results
To date, 10 fellows have participated in the workshop, with plans to require all critical care fellows across all 6 programs in our institution complete the workshop. Participating fellows felt more comfortable than before the workshop with various aspects of discussions with families, including breaking bad news, discussing brain death, and managing conflict. Additionally, participating chaplains and nurses felt that they gained new skills, including participating in a huddle, collaborating with other healthcare professionals, discussing brain death, and managing conflict.
Conclusions
A multi-disciplinary, interprofessional communications simulation improved critical care fellows’ comfort in communication about serious illness care goals. and will be utilized to teach other trainees these essential communication skills.
