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.