Use of Simulation-Based Mastery Learning Curriculum to Improve Difficult Conversation Skills Among Anesthesiologists:...

Area of Science:

• Medical Education
• Anesthesiology
• Communication Skills

Background:

• Breaking bad news (BBN) is a critical clinical skill for physicians, yet standardized training for anesthesiologists is lacking.
• Complications in anesthesiology necessitate effective patient and family communication, which can be stressful for clinicians with low confidence.
• Simulation-based mastery learning (SBML) offers a structured approach to enhance anesthesiologists' BBN skills.

Purpose of the Study:

• To evaluate the effectiveness of an SBML curriculum in improving anesthesiologists' skills and confidence in breaking bad news.
• To assess the impact of a standardized BBN training program on anesthesiologists' communication abilities.

Main Methods:

• Developed an SBML curriculum incorporating the SPIKES framework and NURSE statements for empathy.
• Conducted a pretest-posttest study with anesthesiologists, including didactic sessions and deliberate practice.
• Assessed BBN performance using a 16-item skills checklist before and after the 2-hour curriculum.

Main Results:

• All 20 participants met the minimum passing score on the posttest, compared to only 3 at pretest (P < .001).
• Median participant confidence in BBN skills significantly increased from 3 to 4 (P < .001).
• High overall satisfaction with the curriculum was reported, with a median score of 5.

Conclusions:

• SBML training significantly enhanced anesthesiologists' communication skills and confidence in breaking bad news within a simulated setting.
• The findings suggest a need for further education in BBN for anesthesiologists, with SBML proving an effective method.
• Improved BBN skills are crucial for anesthesiologists to manage challenging patient communication effectively.