Initial Evaluation and Implementation of Simulation-based Death Notification Training for Military Residents

Notifying a patient's family that the patient has died is a delicate and sensitive task in medical practice. This is particularly true in the military population due to the frequent unexpected and sudden nature of death. Medical students in France receive no systematic training in death notification, either in civilian or military settings. Therefore, the researchers sought to (1) assess the initial level of training of military medical residents in announcing death, (2) design an adapted simulation-based training program after the observation of possible gaps, (3) evaluate its impact on their perceived self-efficacy, and (4) assess the program's long-term relevance.

The researchers conducted an observational study followed by a simulation-based educational intervention. First, a questionnaire was distributed to two cohorts of military medical residents, who began their residency in 2023 and 2024. The questionnaire assessed their training level, experience, and perceptions regarding death announcement. Based on the findings, a tailored theoretical and practical simulation-based training was developed and delivered. Pre- and post-training self-assessment questionnaires and a 5-month follow-up survey were used to evaluate the impact and retention of learning outcomes.

A total of 72 residents (45%) completed the initial questionnaire. The mean age of the participants was 25 ± 1.5 years, and 61% of the respondents were female. Most participants (57/72, 79%) specialized in general practice. Only 19% (14/72) had previously announced a death, and 44% (32/72) declared that they had received some form of related training during their curriculum, which was simulation-based for 35% (25/72). Of the 14 residents who had to announce a death, 9 (65%) felt little or not at all prepared. Overall, 40 residents participated in the simulation-based training, which led to a statistically significant improvement (P < .05) in eight out of 10 assessed skills. At 5-month follow-up, all residents who had to deliver a death notification reported the training as useful.

The initial assessment revealed a clear need for specialized training in announcing death for future military physicians. The implemented simulation-based program significantly enhanced the residents' sense of self-efficacy. There is strong support for integrating the program into the curriculum annually, as it appears to effectively improve the quality of care provided to grieving families.