Teaching NICU Fellows How to Relay Difficult News Using a Simulation-Based Curriculum: Does Comfort Lead to...

Area of Science:

• Medical Education
• Neonatal Medicine
• Communication Skills Training

Background:

• Neonatal Intensive Care Unit (NICU) clinicians require effective communication skills to deliver difficult news to families.
• Formal training is established as necessary for NICU trainees, but its impact on objective performance is unclear.

Purpose of the Study:

• To evaluate the effectiveness of a simulation-based communication intervention on Neonatal-Perinatal Medicine fellows' skills in delivering bad news.
• To assess short-term and long-term objectively measured performance changes following the intervention.

Main Methods:

• A simulation-based intervention using the SPIKES protocol was implemented for 15 fellows.
• Participants were evaluated pre-intervention, post-intervention, and at follow-up using blinded rater evaluations, self-assessments, knowledge tests, and standardized parent evaluations.

Main Results:

• Trainees showed improved self-assessment scores and knowledge retention, but blinded rater evaluations revealed no significant improvement and a decline at follow-up.
• First-year fellows scored higher on blinded rater evaluations immediately post-intervention compared to senior fellows.
• Standardized parent evaluations showed no significant differences across assessment stages.

Conclusions:

• Simulation-based training can enhance trainee self-efficacy and knowledge in delivering difficult news.
• Objective performance assessments may not align with self-reported improvements, indicating a need for robust evaluation methods.
• Longitudinal curricula and frequent reinforcement are crucial for sustained skill retention in clinical practice.