Evaluation of the impact of a simulation-enhanced breaking bad news workshop in pediatrics.
BACKGROUND
Our goal was to develop and evaluate the effectiveness of a simulation-based workshop for teaching pediatric trainees' communication skills in breaking bad news.


METHODS
A simulation-based workshop was developed to teach skills in breaking bad news. After a classroom-based introduction, small groups of residents participated in 3 scenarios, each starting with a simulated resuscitation, followed by 2 conversations with the patient's parent, played by actors. Each conversation was observed through a 1-way mirror and was followed by a debriefing. After the workshop, the residents completed workshop evaluations and a self-assessment. Before and after the workshop, residents were evaluated in Objective Structured Clinical Examination stations where they were required to give bad news. Two physician experts and 2 parents who personally experienced receiving bad news about their child evaluated resident performance using a previously validated communication evaluation tool.


RESULTS
Residents' ratings of the workshop were very high for all items, and 100% of the residents reported improvement in their ability to deliver bad news after the workshop. Statistically significant improvement was found in 14 of 17 items of the evaluation tool used by experts and parents, with the parents reporting greater improvement than the experts.


CONCLUSIONS
This reflective, simulation-based workshop successfully improved pediatric trainees' skills in having difficult conversations with families, as evaluated by the participants, by physician experts, and, most importantly, by parents who have experienced these conversations in real life.
From the University of Calgary (K.T., E.G.), Alberta Children's Hospital, Calgary, Alberta, Canada; Northern Kentucky University (C.M.), Highland Heights, KY.
Kathleen
K
Tobler
Estee
E
Grant
Cecile
C
Marczinski
D000328:Adult; D000416:Alberta; D003142:Communication; D004503:Education, Medical, Graduate / Q000379:methods*; D004522:Educational Status; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010372:Pediatrics / Q000193:education*; D011361:Professional Competence; D011368:Professional-Family Relations; D016730:Program Development; D015397:Program Evaluation; D014342:Truth Disclosure