Simulation-Based Palliative Care Communication for Pediatric Critical Care Fellows

Area of Science:

• Medical Education
• Pediatric Critical Care
• Palliative Care Communication

Background:

• Pediatric palliative care (PPC) education is insufficient in pediatric critical care medicine (PCCM) fellowships.
• Fellows and program directors desire enhanced training in difficult conversations.
• Simulation-based training offers experiential practice for critical communication skills.

Purpose of the Study:

• To describe a simulation-based PPC communication curriculum for PCCM fellows.
• To evaluate the effectiveness of this training in improving communication skills.

Main Methods:

• A simulation series involving 28 PCCM fellows from 2011-2017.
• Standardized patients and interprofessional faculty co-facilitated sessions.
• Fellows participated in up to 18 scenarios, evaluated on 4 communication categories.

Main Results:

• 116 evaluations were completed for 18 fellows.
• Median scores for general communication, breaking bad news, and goals of care ranged from 2.0 to 3.0.
• Resuscitation communication scores were lower, ranging from 1.0 to 1.5.

Conclusions:

• The simulation curriculum effectively taught palliative communication techniques.
• Opportunities for improvement exist in complex communication tasks.
• The curriculum provides a model for other pediatric programs, emphasizing the need for further research.