Teaching antenatal counseling skills to neonatal providers.
Counseling a family confronted with the birth of a periviable neonate is one of the most difficult tasks that a neonatologist must perform. The neonatologist's goal is to facilitate an informed, collaborative decision about whether life-sustaining therapies are in the best interest of this baby. Neonatologists are trained to provide families with a detailed account of the morbidity and mortality data they believe are necessary to facilitate a truly informed decision. Yet these complicated and intensely emotional conversations require advanced communication and counseling skills that our current fellowship-training strategies are not adequately providing. We review educational models for training neonatology fellows to provide antenatal counseling at the threshold of viability. We believe that training aimed at teaching these skills should be incorporated into the neonatal-perinatal medicine fellowship. The optimal approaches for teaching these skills remain uncertain, and there is a need for continued innovation and outcomes-based research.
Department of Pediatrics, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, MD. Electronic address: Theophil.Stokes@usuhs.edu.
Theophil A
TA
Stokes
Medical Humanities & Bioethics Program, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Katie L
KL
Watson
Division of Neonatology, Department of Pediatrics. Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins Berman Institute of Bioethics, Baltimore, MD.
Renee D
RD
Boss
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003142:Communication; D032882:Comprehension; D003657:Decision Making; D004503:Education, Medical, Graduate; D005257:Fellowships and Scholarships; D005260:Female; D005328:Fetal Viability; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D009359:Neonatology / Q000193:education* / Q000941:ethics; D010290:Parents / Q000523:psychology; D011247:Pregnancy; D011368:Professional-Family Relations; D011379:Prognosis; D016414:Resuscitation Orders / Q000523:psychology*
Antenatal counseling; Communication; Medical education; Periviable neonate