Perioperative Difficult Conversations With Guardians of Pediatric Patients: A Simulation-Based Workshop for...

Effective communication of adverse events is a critical skill for health care practitioners, particularly those in anesthesiology. Despite the importance of delivering bad news to guardians after complications, many anesthesia practitioners receive little to no formal training in this area. This curriculum aims to address this by introducing a learning activity that integrates the SPIKES and NURSE frameworks with simulated parent (SP) encounters.

A randomized waitlist control design was used to evaluate this 3-hour simulation curriculum. Learners were randomly assigned to receive either immediate training in communication skills (a 1-hour didactic session on the SPIKES and NURSE framework, followed by SP deliberate practice) or delayed training after 1 month. Both groups completed a pretest, posttest, and delayed posttest. Communication skills were evaluated using a published checklist based on the SPIKES and NURSE frameworks. Course surveys were also administered to assess changes in learners' self-reported confidence and overall course satisfaction with the training.

Twenty-one learners (15 attending anesthesiologists and 6 certified registered nurse anesthetists) participated in this educational activity. Both groups demonstrated significant improvements in checklist-scored communication skills and self-reported confidence following the simulation curriculum (P < .001). In the Early Intervention group, these improvements in simulated communication skills were sustained after a 1-month delay. Overall, course satisfaction was high, with a median score of 5 (IQR 5-5).

Our findings demonstrate that a structured curriculum incorporating the SPIKES and NURSE frameworks, combined with SP deliberate practice, enhances communication skills for difficult perioperative conversations with pediatric guardians.