Rapid-cycle deliberate practice: death notification.

Area of Science:

• Medical Education
• Emergency Medicine
• Communication Skills

Background:

• Death notification is a challenging task for emergency physicians lacking prior patient relationships.
• The GRIEV_ING curriculum aims to improve skills and confidence in delivering death notifications.
• Rapid-cycle deliberate practice (RCDP) is a debriefing technique shown to enhance skills in a safe environment.

Purpose of the Study:

• To evaluate the effectiveness of RCDP in teaching the GRIEV_ING death notification curriculum to emergency medicine residents.
• To assess the impact of RCDP on resident confidence, cognitive knowledge, and performance in death notification.

Main Methods:

• A 4-hour pilot curriculum was developed for emergency medicine residents.
• The curriculum included pre- and post-intervention evaluations using cognitive tests, critical action checklists, and self-efficacy surveys.
• A Wilcoxon rank-sum test analyzed score differences between pre- and post-intervention assessments.

Main Results:

• Twenty-two residents participated, showing significant increases in median self-efficacy scores (p ≤ 0.0001).
• Multiple-choice GRIEV_ING scores also increased significantly (p ≤ 0.0001).
• Performance scores for death notification demonstrated a statistically significant improvement (p = 0.0303).

Conclusions:

• The RCDP approach is an effective method for training emergency medicine residents in the GRIEV_ING death notification curriculum.
• This training method is practical, requiring minimal resources beyond trained facilitators.
• RCDP enhances resident competence in sensitive communication during end-of-life care.