Teaching Pediatrics Residents a Communication Framework for Delivering Difficult News: A Randomized Controlled Trial...

Area of Science:

• Medical Education
• Pediatric Residency Training
• Communication Skills

Background:

• Effective communication is crucial for pediatric residents when delivering difficult news (DDN).
• The m-SPIKES (modified setting, perception, involvement, knowledge, empathy, summarize/strategize) framework provides a structured approach to DDN.
• Assessing the comparative effectiveness of different practice modalities for DDN skills is essential.

Purpose of the Study:

• To enhance pediatric residents' skills in delivering difficult news using the m-SPIKES framework.
• To compare the effectiveness of peer role-play versus Rapid Cycle Deliberate Practice (RCDP) in improving DDN skills and m-SPIKES mastery.

Main Methods:

• A pilot randomized controlled trial involved 28 pediatric residents.
• Residents received didactic training on the m-SPIKES framework.
• Participants were randomized to practice via peer role-play or RCDP, with pre- and post-intervention assessments of self-efficacy, communication skills, and m-SPIKES mastery via simulation.

Main Results:

• All residents demonstrated significant improvements in self-efficacy, communication skills, and m-SPIKES mastery post-intervention (P ≤ .001).
• Both peer role-play and RCDP groups showed similar gains in self-efficacy and fundamental communication skills.
• The peer role-play group achieved significantly greater mastery of the m-SPIKES framework compared to the RCDP group (P = .046).

Conclusions:

• The educational intervention significantly improved pediatric residents' difficult news delivery skills.
• Peer role-play demonstrated a significant advantage in achieving mastery of the m-SPIKES communication framework.
• Further research is warranted to ascertain the specific benefits of RCDP in communication skills education.