Evaluation of a Telesimulation Program to Support Psychosocial Communication Training for Neonatology Fellows

Parents of infants in the Neonatal Intensive Care Unit (NICU) frequently experience significant emotional distress, yet neonatology fellows receive limited training in psychosocial support. This study evaluates the use of online standardized-patient simulation to improve fellows' communication skills addressing parent concerns. Fellows (n = 13) completed two virtual interactions with standardized parents, with feedback from a neonatal mental health professional (NMHP), a former NICU parent, and a neonatologist using narrative comments and the Gap-Kalamazoo Communication Skills Assessment Scale. Narrative data underwent thematic analysis, and a within-subjects, repeated measures ANOVA examined communication ratings; knowledge and self-efficacy scores were analyzed using descriptive statistics and paired t-tests. Communication scores differed significantly across raters (F(2, 24) = 6.2, p < 0.007). Fellow and faculty ratings were comparable (p = 0.37), whereas parent ratings exceeded fellow self-ratings (p = 0.005). NMHPs and parents identified more thematic codes than fellows (22/26 and 25/26 vs. 15/26), highlighting information delivery, mental health, relationship building, and communication. Fellows' self-efficacy decreased after participation, (t(12) = 2.88, p = 0.02, d = 0.83). This decline, alongside positive feedback on the simulation's relevance, reflects increased recognition of the complexity of addressing parental distress and underscores the need for ongoing training and real-world application. This study provides preliminary evidence for the feasibility of using online simulation to train neonatology fellows in communication strategies that support the psychosocial needs of NICU parents.