1
|
Kube P, Levy C, Diaz MCG, Dickerman M. Improving the Procedure of Delivering Serious News: Impact of a Six-Month Curriculum for Second Year Pediatric Residents. Am J Hosp Palliat Care 2024; 41:889-894. [PMID: 37822065 DOI: 10.1177/10499091231206562] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
Objective: We implemented and studied a novel curriculum that combined role play, didactic education, and the use of a procedure card for asynchronous learning to improve second-year pediatric residents' skills in delivering serious news. Design: Phase 1 established baseline performance with a self-efficacy survey and observed simulation delivering serious news. Phase 2 included directed education of participants with a validated communication skills training framework. During Phase 3, participants were instructed to review the communication procedure card as a just-in-time reference prior to delivering serious news to patients and their families over 6 months. Following this period, participants completed a second self-efficacy survey and engaged in another observed simulation session delivering serious news. Pre and post intervention performance and self-efficacy were compared. Results: A total of 21 out of 26 (81%) participants completed all phases of this study. Participants had a statistically significant increase (p < .001) in self-efficacy scores post-intervention compared to pre-intervention for each of the skills to effectively deliver serious news: assess understanding, communicate news clearly, allow for silence, respond to emotion, and equip for next steps. Additionally, investigator assessments of participants showed an overall statistically significant improvement (p < .001) in all five communication skills post intervention compared to pre intervention. Conclusions: This curriculum resulted in significantly improved self-efficacy and observed ratings of communication skills in second-year pediatric residents over a 6-month period.
Collapse
Affiliation(s)
- Paige Kube
- Department of Pediatrics, Nemours Children's Health, Delaware/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Carly Levy
- Department of Palliative Medicine, Nemours Children's Health, Delaware/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Maria Carmen G Diaz
- Department of Emergency Medicine, Department of Simulation Medicine, Nemours Children's Health, Delaware/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Mindy Dickerman
- Department of Critical Care Medicine, Department of Palliative Medicine, Nemours Children's Health, Delaware/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| |
Collapse
|
2
|
Hill E, Rao P, Eidelsafy A, McCaffery H, Waanders K, Cousino M. Improved Patient Outcomes and Pediatric Resident Performance With a Parent and Faculty Communication Coaching Curriculum. Clin Pediatr (Phila) 2024; 63:263-271. [PMID: 37475491 DOI: 10.1177/00099228231183502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Communication skills are an important part of patient care, but an often neglected part of residency training. Longitudinal active coaching of communication has the potential to effectively improve communication curricula. A novel communication coach curriculum was implemented with approximately half of a pediatric residency class. Residents were coached by both a parent and faculty coach on multiple occasions throughout their intern year. Effectiveness was evaluated through self-assessment, direct observation, chart review, and follow-up phone calls with families. This longitudinal communication coach curriculum was well-received and resulted in increased self-awareness of communication skills. Coachable behaviors improved in intervention residents, and their patients spoke more positively of their experiences with communication. Additionally, these patients were less likely to be readmitted than patients cared for by control residents. A longitudinal communication coaching model is a feasible and effective curriculum for pediatric residents.
Collapse
Affiliation(s)
- Elizabeth Hill
- Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Priyanka Rao
- Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amged Eidelsafy
- Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Chemistry, University of Washington, Seattle, WA, USA
| | - Harlan McCaffery
- Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Katherine Waanders
- Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Melissa Cousino
- Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
3
|
Kase SM, Christianson CA, Dow LA, Guttmann KF, Weintraub AS. PedsTalk: A Pilot Communication Skills Education Course for Pediatric Residents. Hosp Pediatr 2023; 13:e377-e383. [PMID: 38018161 DOI: 10.1542/hpeds.2023-007174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
OBJECTIVE Communication skills are critical to pediatric practice, but few pediatric residency programs provide formal communication skills education. Pediatric residents often lack confidence in these skills. We hypothesized that a simulation-based communication skills course would improve resident confidence in the skills required for serious illness conversations with patients/families. METHODS In collaboration with multidiscipline VitalTalk-trained faculty, we developed PedsTalk, a communication skills course for pediatric residents based on the VitalTalk framework. In PedsTalk, faculty/peers offered real-time coaching during simulation sessions with actors. Resident participants self-rated confidence in 9 communication skills using a 5-point Likert scale before, immediately after, and 4 months after course participation, with course nonparticipants serving as controls. Responses were analyzed by using Friedman tests and Wilcoxon rank tests. Thematic analysis was conducted to identify themes among free-text responses. RESULTS Twenty-seven pediatric residents participated in PedsTalk, 11 of whom completed survey assessments at all timepoints. Eleven course nonparticipants served as controls. Over time, participants' confidence in the following communication skills was retained or significantly improved: "difficult conversations" (P < .001), "recognizing emotion" (P < .01), "using silence" (P < .008), "headline statements" (P < .001), eliciting "VALUES" (P < .001), and asking "permission to continue" (P < .001). Over time, controls had significant improvements in confidence in 2 skills: headline statements (P < .014) and eliciting "VALUES" (P < .031). CONCLUSIONS PedsTalk is a novel approach to communication skills education in pediatric residency. Participation improved residents' confidence in 6 communication skills, including overall confidence in having difficult conversations. Although confidence in some skills may naturally develop through clinical experiences, PedsTalk further enhances communication skills education among trainees.
Collapse
Affiliation(s)
| | - Caroline A Christianson
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Hassenfeld Children's Hospital at NYU Langone Health, NYU Grossman School of Medicine, New York, New York
| | - Lindsay A Dow
- Brookdale Department of Geriatrics and Palliative Medicine
| | - Katherine F Guttmann
- Division of Newborn Medicine, Department of Pediatrics,Icahn School of Medicine at Mount Sinai, New York, New York
| | - Andrea S Weintraub
- Division of Newborn Medicine, Department of Pediatrics,Icahn School of Medicine at Mount Sinai, New York, New York
| |
Collapse
|
4
|
Niehaus JZ, Slaven JE, Fettig L. Virtual Adaptation of Empathetic Communication Training for Pediatric Interns. Am J Hosp Palliat Care 2023; 40:1074-1078. [PMID: 36863861 DOI: 10.1177/10499091221145921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
OBJECTIVE Evaluate feasibility and effectiveness of virtual adaptation of in-person simulation-based empathetic communication training. METHODS Pediatric interns participated in virtual training session then completed post-session and 3 months follow up surveys. RESULTS Self-reported preparedness on the skills all improved significantly. The interns report the educational value as extremely high both immediately after and 3 months after training. 73% of the interns report using the skills at least weekly. CONCLUSION A 1 day virtual simulation-based communication training is feasible, well received, and similarly effective as in-person training.
Collapse
Affiliation(s)
- Jason Z Niehaus
- Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - James E Slaven
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lyle Fettig
- Division of Hospice and Palliative Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
5
|
Baudou E, Guilbeau-Frugier C, Tack I, Muscari F, Claudet I, Mas E, Taillefer A, Breinig S, Bréhin C. Clinical decision-making training using the Script Concordance Test and simulation: A pilot study for pediatric residents. Arch Pediatr 2023:S0929-693X(23)00056-8. [PMID: 37147153 DOI: 10.1016/j.arcped.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 12/06/2022] [Accepted: 03/25/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Each year, new pediatric residents begin their shifts in the pediatric emergency room. While technical skills are often acquired during workshops, non-technical skills such as communication, professionalism, situational awareness, or decision-making are rarely tested. Simulation enables non-technical skills to be developed in situations frequently encountered in pediatric emergencies. Adopting an innovative approach, we combined two pedagogical methods: the Script Concordance Test (SCT) and simulation to improve clinical reasoning and non-technical skills of first-year pediatric residents in dealing with clinical situations involving febrile seizures. The aim of this work is to report the feasibility of such a combined training. METHODS The first-year pediatric residents participated in a training session on how to manage a child attending the emergency department with a febrile seizure. At the beginning of the session, the trainees had to complete the SCT (seven clinical situations) and then participated in three simulation scenarios. Student satisfaction was assessed by means of a questionnaire at the end of the session. RESULTS In this pilot study, 20 residents participated in the training. The SCT scores for the first-year pediatric residents were lower and more widely distributed than those of the experts with better concordance for diagnostic items compared to investigation or treatment items. All were satisfied with the teaching methods employed. Further sessions on additional topics relating to the management of pediatric emergency cases were requested. CONCLUSION Although limited by the small size of our study, this combination of teaching methods was possible and seemed promising for the development of non-technical skills of pediatric residents. These methods are in line with the changes being made to the third cycle of medical studies in France and can be adapted to other situations and other specialties.
Collapse
Affiliation(s)
- E Baudou
- Unité de Neurologie Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | | | - I Tack
- Explorations Fonctionnelles Physiologiques, Hôpital Rangueil, CHU de Toulouse, Toulouse, France
| | - F Muscari
- Unité de Chirurgie Digestive, CHU de Toulouse, Toulouse, France
| | - I Claudet
- Unité d'Urgences et Infectiologie Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - E Mas
- Unité de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, CHU de Toulouse, F-31300, IRSD, Université de Toulouse, INSERM, INRAE, ENVT, UPS, Toulouse, France
| | - A Taillefer
- Unité d'Urgences et Infectiologie Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - S Breinig
- Unité de Réanimation Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - C Bréhin
- Unité d'Urgences et Infectiologie Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France.
| |
Collapse
|
6
|
Rojas CR, Coffin A, Taylor A, Ortiz P, Jenicek G, Hart J, Callahan JM, Shaw KN. Resident Communication With Patients and Families Preferring Languages Other Than English. Hosp Pediatr 2023:191228. [PMID: 37125495 DOI: 10.1542/hpeds.2022-007003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVES Patients and families preferring languages other than English (LOE) often experience inequitable communication with their health care providers, including the underutilization of professional interpretation. This study had 2 aims: to characterize resident-perceived communication with families preferring LOE and to evaluate the impact of language preference on frequency of resident interactions with hospitalized patients and families. METHODS This was a cross-sectional study at a quaternary care children's hospital. We developed a questionnaire for residents regarding their interactions with patients preferring LOE. We concurrently developed a communication tracking tool to measure the frequency of resident communication events with hospitalized patients. Data were analyzed with logistic and Poisson regression models. RESULTS Questionnaire results demonstrated a high level of resident comfort with interpretation, though more than 30% of residents reported "sometimes" or "usually" communicating with families preferring LOE without appropriate interpretation (response rate, 47%). The communication tracking tool was completed by 36 unique residents regarding 151 patients, with a 95% completion rate. Results demonstrated that patients and families preferring LOE were less likely to be present on rounds compared with their counterparts preferring English (adjusted odds ratio, 0.17; 95% confidence interval [CI], 0.07-0.39). Similarly, patients and families preferring LOE were less likely to receive a resident update after rounds (adjusted odds ratio, 0.29; 95% CI, 0.13-0.62) and received fewer resident updates overall (incidence rate ratio, 0.45; 95% CI, 0.30-0.69). CONCLUSIONS Hospitalized patients and families preferring LOE experience significant communication-related inequities. Ongoing efforts are needed to promote equitable communication with this population and should consider the unique role of residents.
Collapse
Affiliation(s)
- Christina R Rojas
- Department of Pediatrics
- Division of Emergency Medicine, Children's National Hospital, Washington, District of Columbia; and
| | | | | | | | | | - Jessica Hart
- Department of Pediatrics
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - James M Callahan
- Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kathy N Shaw
- Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
7
|
Adam P, Mauksch LB, Brandenburg DL, Danner C, Ross VR. Optimal training in communication model (OPTiCOM): A programmatic roadmap. PATIENT EDUCATION AND COUNSELING 2023; 107:107573. [PMID: 36410312 DOI: 10.1016/j.pec.2022.107573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Teaching primary care residents patient communication skills is essential, complex, and impeded by barriers. We find no models guiding faculty how to train residents in the workplace that integrate necessary system components, the science of physician-patient communication training and competency-based medical education. The aim of this project is to create such a model. METHODS We created OPTiCOM using four steps: (1) communication educator interviews, analysis and theme development; (2) initial model construction; (3) model refinement using expert feedback; (4) structured literature review to validate, refine and finalize the model. RESULTS Our model contains ten interdependent building blocks organized into four developmental tiers. The Foundational value tier has one building block Naming relationship as a core value. The Expertize and resources tier includes four building blocks addressing: Curricular expertize, Curricular content, Leadership, and Time. The four building blocks in the Application and development tier are Observation form, Faculty development, Technology, and Formative assessment. The Language and culture tier identifies the final building block, Culture promoting continuous improvement in teaching communication. CONCLUSIONS OPTiCOM organizes ten interdependent systems building blocks to maximize and sustain resident learning of communication skills. Practice Implications Residency faculty can use OPTiCOM for self-assessment, program creation and revision.
Collapse
Affiliation(s)
- Patricia Adam
- Department of Family Medicine and Community Health, University of Minnesota, Smiley's Clinic, 2020 East 28th Street, Minneapolis, MN 55407, USA.
| | - Larry B Mauksch
- Emeritus - Department of Family Medicine, University of Washington, Home, 6026 30th Ave NE, Seattle, WA 98115, USA.
| | - Dana L Brandenburg
- Department of Family Medicine and Community Health, University of Minnesota, Smiley's Clinic, 2020 East 28th Street, Minneapolis, MN 55407, USA.
| | - Christine Danner
- Department of Family Medicine and Community Health, University of Minnesota, Bethesda Clinic, 580 Rice St, St Paul, MN 55103, USA.
| | - Valerie R Ross
- University of Washington Department of Family Medicine, Family Medicine Residency Program, Box 356390, 331 N.E. Thornton Place, Seattle, WA 98125, USA.
| |
Collapse
|
8
|
Selling SK, Kirkey D, Goyal T, Singh A, Gold CA, Hilgenberg SL, Weimer-Elder B, Kuo KW, Rassbach CE. Impact of a relationship-centered care communication curriculum on pediatric residents' practice, perspectives, and opportunities to Develop expertise. PATIENT EDUCATION AND COUNSELING 2022; 105:1290-1297. [PMID: 34538683 DOI: 10.1016/j.pec.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 08/03/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To investigate the impacts of a Relationship-Centered Care (RCC) communication curriculum with coaching on pediatric residents 1) self-reported use of RCC strategies and perspectives, and 2) opportunities to develop adaptive expertise. METHODS Residents (n = 77) completed a 4 h RCC training and shared resultant RCC goals with Coaches (n = 15). Data included resident surveys and reflections immediately post-training, and resident and coach surveys 6-months later. Reported use of RCC strategies were compared over time with paired t-tests. Qualitative data were analyzed using open coding guided by sensitizing principles from the RCC framework and adaptive expertise. RESULTS Pediatric residents reported significant increases (p < 0.001) in use of 4/9 RCC strategies after 6 months: eliciting all concerns, chunking information, checking for understanding, and teach-back. Resident reflections highlighted shifts in perspective around RCC. Training combined with coaching provided opportunities for residents to develop adaptive expertise through adapting and innovating across settings and contexts. CONCLUSION Residents had significant increases in reported use of key RCC strategies after a training combined with coaching and demonstrated opportunities to develop adaptive expertise. PRACTICE IMPLICATIONS Residency programs should include RCC training with an emphasis on the new and challenging strategies and provide opportunities to practice and receive coaching.
Collapse
Affiliation(s)
| | - Danielle Kirkey
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Tarini Goyal
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Amit Singh
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Carl A Gold
- Department of Neurology & Neurological Sciences, Stanford University, Stanford, CA, USA.
| | - Sarah L Hilgenberg
- Department of Pediatrics, Stanford School of Medicine, Stanford, CA, USA.
| | | | - Kevin Wu Kuo
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Caroline E Rassbach
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| |
Collapse
|
9
|
Howell HB, Desai PV, Altshuler L, McGrath M, Ramsey R, Vrablik L, Levy FH, Zabar S. Teaching and Assessing Communication Skills in Pediatric Residents: How Do Parents Think We Are Doing? Acad Pediatr 2022; 22:179-183. [PMID: 34186252 DOI: 10.1016/j.acap.2021.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/14/2021] [Accepted: 06/21/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Curricula designed to teach and assess the communication skills of pediatric residents variably integrates the parent perspective. We compared pediatric residents' communication skills in an objective structured clinical exam (OSCE) case as assessed by Family Faculty (FF), parents of pediatric patients, versus standardized patients (SP). METHODS Residents participated in an OSCE case with a SP acting as a patient's parent. We compared resident performance as assessed by FF and SP with a behaviorally-anchored checklist. Items were rated as not done, partly done or well done, with well-done indicating mastery. The residents evaluated the experience. RESULTS 42 residents consented to study participation. FF assessed a lower percentage of residents as demonstrating skill mastery as compared to SP in 19 of the 23 behaviors. There was a significant difference between FF and SP for Total Mastery Score and Mastery of the Competency Scores in three domains (Respect and Value, Information Sharing and Participation in Care and Decision Making). The majority of residents evaluated the experience favorably. CONCLUSION Involving parents of pediatric patients in the instructive and assessment components of a communication curriculum for pediatric residents adds a unique perspective and integrates the true stakeholders in parent-physician communication.
Collapse
Affiliation(s)
- Heather B Howell
- Department of Pediatrics, New York University Grossman School of Medicine (HB Howell, PV Desai, L Vrablik, and FH Levy), New York, NY.
| | - Purnahamsi V Desai
- Department of Pediatrics, New York University Grossman School of Medicine (HB Howell, PV Desai, L Vrablik, and FH Levy), New York, NY
| | - Lisa Altshuler
- Department of Medicine, New York University Grossman School of Medicine (L Altshuler and S Zabar), New York, NY
| | - Meaghan McGrath
- Sala Institute for Child and Family Centered Care, Hassenfeld Children's Hospital (M McGrath, R Ramsey and FH Levy), New York, NY
| | - Rachel Ramsey
- Sala Institute for Child and Family Centered Care, Hassenfeld Children's Hospital (M McGrath, R Ramsey and FH Levy), New York, NY
| | - Lauren Vrablik
- Department of Pediatrics, New York University Grossman School of Medicine (HB Howell, PV Desai, L Vrablik, and FH Levy), New York, NY
| | - Fiona H Levy
- Department of Pediatrics, New York University Grossman School of Medicine (HB Howell, PV Desai, L Vrablik, and FH Levy), New York, NY; Sala Institute for Child and Family Centered Care, Hassenfeld Children's Hospital (M McGrath, R Ramsey and FH Levy), New York, NY
| | - Sondra Zabar
- Department of Medicine, New York University Grossman School of Medicine (L Altshuler and S Zabar), New York, NY
| |
Collapse
|
10
|
Lakhaney D, Banker SL, O’Connor A, Barugel J, Gati SB, Bloomhardt HM, Mo C. A Codeveloped Family-Faculty Curriculum to Improve Trainee Communication. Pediatrics 2022; 149:183797. [PMID: 35226752 PMCID: PMC9645684 DOI: 10.1542/peds.2021-051715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 01/03/2023] Open
Affiliation(s)
- Divya Lakhaney
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York,Address correspondence to Divya Lakhaney, Columbia University Irving Medical Center, Department of Pediatrics, Division of Critical Care and Hospital Medicine, 622 West 168th St, VC4-417, New York, NY 10032. E-mail:
| | - Sumeet L. Banker
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Annie O’Connor
- Family Advisory Council, Morgan Stanley Children’s Hospital, New York-Presbyterian Hospital, New York, New York
| | - Julia Barugel
- Family Advisory Council, Morgan Stanley Children’s Hospital, New York-Presbyterian Hospital, New York, New York
| | - Stephanie B. Gati
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Hadley M. Bloomhardt
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Cecilia Mo
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
11
|
Hilgenberg SL, Frintner MP, Blankenburg RL, Haftel HM, Gellin CE. Categorical Pediatric Residency Program Curriculum Needs: A Study of Graduating Residents and Residency Program Leadership. Acad Pediatr 2021; 21:589-593. [PMID: 33011294 DOI: 10.1016/j.acap.2020.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Pediatric residency programs must adapt their curriculum to meet evolving patient needs yet face limited resources to implement changes resulting in gaps. We performed a categorical pediatric residency program curriculum needs assessment to inform curriculum development efforts. METHODS We analyzed data from the 2017 American Academy of Pediatrics Annual Survey of Graduating Residents and pediatric program and associate program director polls conducted at a 2019 pediatric residency program director national meeting. We used conventional content analysis to code and categorize. RESULTS Participants included 528 (53%) graduating residents representing 88% of programs, 89 program directors, and 177 associate program directors representing at minimum 45% of programs. Participants demonstrated concordance on the top 4 needs-additional clinical experiences, career development, business of medicine, and health systems. Program leaders also identified wellness and resiliency; disparities; diversity, equity, and inclusion; and communication. CONCLUSIONS This is the first categorical pediatric program general curriculum needs assessment conducted of pediatric leadership and graduating residents in over a decade. While program leadership and resident data were collected 2 years apart, we found concordance on the top 4 categories and consistency with prior national needs assessments with the exception of career development. New curriculum development efforts are underway.
Collapse
Affiliation(s)
- Sarah L Hilgenberg
- Department of Pediatrics, Lucile Packard Children's Hospital, Stanford School of Medicine (SL Hilgenberg and RL Blankenburg), Stanford, Calif.
| | - Mary Pat Frintner
- Health Services Research, American Academy of Pediatrics (MP Frintner), Itasca, Ill
| | - Rebecca L Blankenburg
- Department of Pediatrics, Lucile Packard Children's Hospital, Stanford School of Medicine (SL Hilgenberg and RL Blankenburg), Stanford, Calif
| | - Hilary M Haftel
- Education, American Academy of Pediatrics (HM Haftel), Itasca, Ill
| | - Caren E Gellin
- Department of Pediatrics, University of Rochester (CE Gellin), Rochester, NY
| |
Collapse
|
12
|
Hilgenberg SL, Bogetz AL, Leibold C, Blankenburg RL. Advancing Our Understanding of Pediatric Resident Communication Skills and Disruptive Behavior and Mistreatment Strategies. Acad Pediatr 2021; 21:435-437. [PMID: 33220461 DOI: 10.1016/j.acap.2020.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/29/2020] [Accepted: 10/31/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Sarah L Hilgenberg
- Department of Pediatrics, Lucile Packard Children's Hospital, Stanford School of Medicine (SL Hilgenberg and RL Blankenburg), Palo Alto, Calif.
| | | | - Collin Leibold
- University of Massachusetts School of Medicine (C Leibold), Worcester, Mass
| | - Rebecca L Blankenburg
- Department of Pediatrics, Lucile Packard Children's Hospital, Stanford School of Medicine (SL Hilgenberg and RL Blankenburg), Palo Alto, Calif
| |
Collapse
|
13
|
Niehaus JZ, Palmer MM, Slaven JE, Fettig L. Teaching Empathic Communication to Pediatric Interns: Immediate and 3-Month Impact. Am J Hosp Palliat Care 2021; 38:1451-1456. [PMID: 33657877 DOI: 10.1177/1049909121999791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Evaluate pediatric intern self-reported preparedness to Deliver Serious News, Express Empathy, and Medical Error Disclosure after a 1-day simulation based-empathic communication training. Additionally, we sought to evaluate self-reported use of communication skills and describe the clinical scenarios in which the skills were used. METHODS Pediatric interns completed the survey immediately and 3 months after participating in the communication course. RESULTS Self-reported preparedness to Deliver Serious News, Express Empathy, and Medical Error Disclosure all significantly improved. At 3 months, 73.9% of respondents reported using the skills at least weekly and 62% described the clinical scenarios in which they used skills. These descriptions show an ability to use the skills appropriately, and in some cases apply the skills in advanced, more difficult scenarios. CONCLUSION A 1 day simulation-based reflective teaching course for pediatric interns is an effective way to teach empathic communication skills. They feel more prepared to deliver serious news, respond with empathy and disclose a medical error. In addition, the interns value the training as a part of their education and report using the skills in appropriate scenarios at 3 months.
Collapse
Affiliation(s)
- Jason Z Niehaus
- Division of Neonatal-Perinatal Medicine, 12250Indiana University School of Medicine, Indianapolis, IN, USA
| | - Megan M Palmer
- Department of Emergency Medicine, 12250Indiana University School of Medicine, Indianapolis, IN, USA
| | - James E Slaven
- Department of Biostatistics, 12250Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lyle Fettig
- Division of Hospice and Palliative Medicine, 12250Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
14
|
Marsh MC, Reed SM, Mahan JD, Schneider L, Fernandes AK, Liao N, Spears I, Lauden S. Advanced Multimodal Communication Curriculum for Pediatric Residents. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2021; 8:23821205211035239. [PMID: 34869900 PMCID: PMC8642051 DOI: 10.1177/23821205211035239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/08/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Medical educators juggle competing demands as they seek to integrate medical advancements and new technology with the call for earlier introduction to clinical experiences. Newer models of medical education place even greater emphasis on the importance of deliberate training of providers who can deliver compassionate patient-centered care. The need for adaptable, effective communication skills training has never been more relevant than now, in our high-tech and ever-evolving learning climate. METHODS At a large pediatric academic center, we used Kern's six-step approach to complete a needs assessment, identify goals and learning preferences of trainees, and ultimately develop and evaluate a multimodal communication curriculum. This curriculum was rooted in the Accreditation Council for Graduate Medical Education's Pediatric Milestones, with the goal of enhancing knowledge, skills, and competency. Pediatric interns were randomized to either the new curriculum (n = 19) or the existing didactic-based communication training (n = 17) from 2019 to 2020. We evaluated the impact of the new and traditional curriculum through evaluations by expert facilitators, learner surveys, and faculty-assigned resident milestones. RESULTS Many trainees self-identified performance gaps in communication skills at baseline. Eighteen residents attended 1 to 6 in-person deliberate practice workshops. Workshop participation by the residents varied over time due to a variety of factors. All residents, regardless of curricular exposure, showed statistically significant improvement in communication milestones from first to second year and those enrolled in the deliberate practice curriculum highly valued the workshops and coaching. DISCUSSION Our curriculum demonstrates the value of deliberate practice opportunities for residents to gain skills in advanced communication. Residents appreciated this type of training and the time devoted to expand these skills. Lessons learned and barriers to implementation from this curriculum can be helpful for educators interested in integrating active, deliberate practice, simulation-based communication training into their current educational model.
Collapse
Affiliation(s)
| | | | - John D Mahan
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University College of Medicine, Columbus, OH,
USA
| | - Lydia Schneider
- The Ohio State University College of Medicine, Columbus, OH,
USA
| | - Ashley K Fernandes
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University College of Medicine, Columbus, OH,
USA
| | - Nancy Liao
- Nationwide Children's Hospital, Columbus, OH, USA
| | - Isaac Spears
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University College of Medicine, Columbus, OH,
USA
| | | |
Collapse
|
15
|
Pitt MB, Poitevien P, Blankenburg R. Vision 2020: A Year in (Re)View From the Association of Pediatric Program Directors. Acad Pediatr 2021; 21:16-18. [PMID: 32828951 PMCID: PMC7439088 DOI: 10.1016/j.acap.2020.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Michael B Pitt
- Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Minnesota School of Medicine & Masonic Children's Hospital (MB Pitt), Minneapolis, Minn.
| | - Patricia Poitevien
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Warren Alpert Medical School at Brown University & Hasbro Children's Hospital (P Poitevien), Providence, RI
| | - Rebecca Blankenburg
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine & Lucile Packard Children's Hospital (R Blankenburg), Palo Alto, Calif
| |
Collapse
|