Affiliations: Department of Pediatrics and Communicable Disease,
University of Michigan, Ann Arbor, MI, USA | Department of Pediatrics and Communicable Disease and
Department of Medical Education, University of Michigan, Ann Arbor, MI,
USA | Department of Medical Education, University of
Michigan, Ann Arbor, MI, USA
Note: [] Corresponding author: Mohammad A. Attar, MD, F5790 Mott Hospital,
1500 E. Medical Center Drive, Ann Arbor, MI 48109-5254, USA. Tel.: +1 734 763
4109; Fax: +1 734 763 2278; E-mail: [email protected]
Abstract: Purpose: To develop, implement, and evaluate a longitudinal
skills-based curriculum to teach pediatric residents a model for communicating
bad news (CBN) that includes eliciting spiritual needs. Method: Prospective longitudinal design of a curriculum that included instructional
sessions, peer role-playing, and opportunities to receive faculty feedback
during neonatal intensive care unit rotations. The study cohort included all
(n=23) Pediatric and Medicine-Pediatric residents who began their training
in 2005. Outcome measures included performance on a CBN standardized patient
(SP) exercise and self-assessments of confidence. The CBN SP checklist included
a general communication skills component. The performance of the study cohort
as third year residents was compared to that of a control group (n=11, first
year sub-specialty pediatric fellows who began their training in 2008). Results: The study group had significantly higher scores than the comparison
group in CBN SP exercises. The study group more frequently explored the
parent's need for spiritual support than the control group. The study group
also had significant improvements in their self-assessed confidence in CBN and
in their communication scores over the course of the curriculum. Conclusion: Enhanced SP-assessment performance and self-perceived competency
support the feasibility and efficacy of a longitudinal CBN curriculum in a
pediatric residency program.
