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INFORM: A Pediatrician's Communication Curriculum About Diagnostic Conversations in Somatic Symptom and Related
Florence Lambert-Fliszar1, Catherine Sullivan2, Christina Giudice3
1Assistant Professor, Division of Pediatric Hospital Medicine, Department of Pediatrics, Geisel School of Medicine at Dartmouth.
Introduction:
Somatic symptom and related disorders (SSRDs) is an umbrella term for physical symptoms related to or amplified by psychosocial factors. Clinicians find difficulty in delivering SSRD diagnoses to families. Caregiver buy-in of an SSRD diagnosis is strongly associated with better outcomes. Curricula addressing gaps in this communication skill are lacking, indicating a need for effective educational innovations to increase pediatricians' confidence and efficacy in SSRD diagnostic conversations with caregivers.
Methods:
A 90-minute curriculum composed of didactic and experiential components, including role-play, was designed using Kern's six steps to curriculum development and the INFORM framework (Introduce, Name and Narrate, Feedback, Orient to diagnosis, Reframe, Management principles). We evaluated and improved the curriculum over multiple iterations using the CIPP (Context-Input-Process-Product) model, in which acceptability and feasibility data were collected from participants via quantitative surveys. These surveys also assessed attainment of educational objectives.
Results:
A total of 85 responses (of 97 total participants; 88%) were obtained from pediatric residents, pediatric hospital medicine fellows, and pediatric hospitalist attendings. Based on survey responses to two of three true/false questions, participants demonstrated significantly improved knowledge postcurriculum. The proportion of learners reporting feeling confident in SSRD diagnostic conversations increased, from 32% before to 86% after the curriculum. A total of 95% of respondents would recommend this curriculum to a colleague, and 98% reported they would use their skills in future clinical practice.
Discussion:
We created a novel, well-received SSRD diagnostic communication curriculum via an iterative process, with demonstration of achieved educational objectives.
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