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Published on: March 29, 2019
Benefit of Simulation-Based Training in Medical Adverse Events Disclosure in Pediatrics
Juliette Aubin1, Océane Rivolet1, Anne-Laure Taunay1
1From the Pediatric Emergency Department.
Insights
Pediatric residents improved adverse event disclosure skills through simulation-based training and mastery learning. This training enhances communication, confidence, and knowledge, crucial for patient safety and trust.
Area of Science:
- Medical Education
- Patient Safety
- Healthcare Communication
Background:
- Adverse events (AEs) in healthcare represent a significant public health concern.
- Effective disclosure of AEs is a critical yet challenging task for healthcare providers.
Purpose of the Study:
- To evaluate the impact of simulation-based training on pediatric residents' performance in disclosing AEs to simulated parents.
- To assess correlations between disclosure performance and demographic/experiential factors.
- To measure knowledge gain and resident satisfaction with the training.
Main Methods:
- Prospective study involving 49 pediatric residents undergoing two simulation sessions (SIM 1 and SIM 2) at a 3-week interval.
- Intervention group received mastery learning training (didactic and role-playing) after SIM 1; control group received training after SIM 2.
- Performance assessed by independent observers and simulated parents; knowledge evaluated via pre/post-tests.
Main Results:
- The intervention group showed significant improvement in AE disclosure performance scores from SIM 1 to SIM 2 (P=0.02).
- Simulated parents' subjective scores also increased significantly post-training (P<0.01).
- Residents reported increased self-confidence (P=0.04) and knowledge gain (P=0.02), expressing satisfaction with the training.
Conclusions:
- Simulation-based training coupled with mastery learning effectively enhances pediatric residents' ability to disclose adverse events.
- Improved AE disclosure training is vital for maintaining family confidence in physicians and mitigating potential legal issues.
Introduction:
Adverse events (AEs) in health care are a public health issue. Although mandatory, error disclosure is experienced by health providers as a difficult task.
Methods:
In this prospective study, the primary objective was to assess performance in disclosing AEs to simulated parents using a validated scale before and after training among a pediatric residents' population. Secondary objectives were to assess correlation with year of residency, sex, and previous experience and to analyze gain in knowledge (theoretical pretest/posttest scores) and satisfaction. Two evaluation simulations (simulation [SIM] 1 and SIM 2) were scheduled at 3-week interval. In the intervention group, mastery learning was offered after SIM 1 including a didactic approach and a training session using role-playing games. For the control group, the course was carried out after SIM 2. Assessments were performed by 2 independent observers and simulated parents.
Results:
Forty-nine pediatric residents performed 2 scenarios of AE disclosure in front of simulated parents. In the intervention group, performance scores on SIM 2 (72.36 ± 5.40) were higher than on SIM 1 (65.08 ± 9.89, P = 0.02). In the control group, there was no difference between SIM 1 and SIM 2 (P = 0.62). The subjective scores from simulated parents showed the same increase on SIM 2 (P < 0.01). There was no correlation with the residents' previous experience or their residency year. There was an increase in self-confidence (P = 0.04) for SIM 2. There was also an increase in posttest theoretical scores (P = 0.02), and residents were satisfied with the training.
Conclusions:
This study showed the benefits of simulation-based training associated with mastery learning in AE disclosure among pediatric residents. It is important to train residents for these situations to avoid traumatic disclosure generating a loss of confidence of the family regarding physicians and possible lawsuits.
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