Pediatric Palliative Care Simulation Improves Resident Learning Outcomes: An 11-Year Review.

Area of Science:

• Medical Education
• Pediatric Palliative Care
• Simulation-Based Learning

Background:

• General pediatrics residents often have limited exposure to practicing difficult conversations, especially concerning end-of-life care.
• Simulation learning offers an effective method for honing professional skills.
• Pediatric palliative care (PPC) physicians are well-positioned to mentor trainees in leading challenging discussions via simulation.

Purpose of the Study:

• To document an 11-year experience utilizing simulated difficult conversations with bereaved parent actors.
• To assess the impact of simulation on resident and fellow performance in critical communication scenarios.

Main Methods:

• Two distinct simulations were developed by PPC physicians to train clinical learners in managing difficult conversations.
• Simulations involved co-facilitation by bereaved parents and hospital chaplains.
• Performance was evaluated using a rubric based on the Accreditation Council for Graduate Medical Education (ACGME) Core Competencies.

Main Results:

• Residents showed significant improvement in 16/21 ACGME criteria in the first scenario (infant death) and 10/21 in the second (goals-of-care).
• Fellows demonstrated high baseline scores, with no significant improvement noted in either scenario.
• The simulation approach proved effective in enhancing resident performance and comfort levels.

Conclusions:

• Simulations involving bereaved parent actors effectively enhance general pediatrics residents' performance and comfort in difficult conversations.
• This simulation model is adaptable and can be implemented in various educational settings.
• Simulation provides a valuable tool for preparing pediatric trainees for challenging family discussions.