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Impact of a Simulation-Based Communication Workshop on Resident Preparedness for End-of-Life Communication in the Intensive Care Unit.

Markin A, Cabrera-Fernandez DF, Bajoka RM, Noll SM, Drake SM, Awdish RL, Buick DS, Kokas MS, Chasteen KA, Mendez MP - Crit Care Res Pract (2015)

Bottom Line: Results.Conclusion.This study provides evidence that brief simulation-based interventions can produce lasting improvements in residents' confidence to discuss EOL care with family members of patients in the ICU.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA.

ABSTRACT
Introduction. Although residents frequently lead end-of-life (EOL) discussions in the intensive care unit (ICU), training in EOL care during residency has been required only recently, and few educational interventions target EOL communication in the ICU. This study evaluated a simulation-based intervention designed to improve resident EOL communication skills with families in the ICU. Methods. Thirty-four second-year internal medicine residents at a large urban teaching hospital participated in small group sessions with faculty trained in the "VitalTalk" method. A Likert-type scale questionnaire measured self-assessed preparedness before, immediately following, and approximately 9 months after intervention. Data were analyzed using Wilcoxon rank-sum analysis. Results. Self-assessed preparedness significantly improved for all categories surveyed (preintervention mean; postintervention mean; p value), including discussing bad news (3.3; 4.2; p < 0.01), conducting a family conference (3.1; 4.1; p < 0.01), discussing treatment options (3.2; 3.9; p < 0.01), discussing discontinuing ICU treatments (2.9; 3.5; p < 0.01), and expressing empathy (3.9; 4.5; p < 0.01). Improvement persisted at follow-up for all items except "expressing empathy." Residents rated the educational quality highly. Conclusion. This study provides evidence that brief simulation-based interventions can produce lasting improvements in residents' confidence to discuss EOL care with family members of patients in the ICU.

No MeSH data available.


Resident self-assessed preparedness prior to the intervention (n = 38), after the intervention (n = 32), and at 9-month follow-up (n = 18). All p < 0.05 except “expressing empathy” at follow-up (p = 0.12). Error bars show standard deviation. ICU, intensive care unit.
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fig1: Resident self-assessed preparedness prior to the intervention (n = 38), after the intervention (n = 32), and at 9-month follow-up (n = 18). All p < 0.05 except “expressing empathy” at follow-up (p = 0.12). Error bars show standard deviation. ICU, intensive care unit.

Mentions: Self-assessed preparedness significantly increased immediately following the intervention for all items surveyed (Figure 1). Mean score increases on the 5-point Likert scale (1, not well prepared; 3, somewhat prepared; 5, very well prepared; with 2 and 4 corresponding to intermediate values) were significant: giving bad news to a family (0.91, p < 0.01), conducting a family conference (1.0, p < 0.01), expressing empathy (0.58, p < 0.01), discussing treatment options and palliative care with families of critically ill patients (0.66, p = 0.01), responding to families who deny the seriousness of their loved one's illness (0.94, p < 0.01), and discussing discontinuing intensive care treatments (0.67, p < 0.01). The Friedman test revealed significant differences between the 3 assessments. Wilcoxon signed-rank tests demonstrated that scores improved to initial baseline for all items at the 9-month follow-up (Figure 1) except for “expressing empathy” (p = 0.12).


Impact of a Simulation-Based Communication Workshop on Resident Preparedness for End-of-Life Communication in the Intensive Care Unit.

Markin A, Cabrera-Fernandez DF, Bajoka RM, Noll SM, Drake SM, Awdish RL, Buick DS, Kokas MS, Chasteen KA, Mendez MP - Crit Care Res Pract (2015)

Resident self-assessed preparedness prior to the intervention (n = 38), after the intervention (n = 32), and at 9-month follow-up (n = 18). All p < 0.05 except “expressing empathy” at follow-up (p = 0.12). Error bars show standard deviation. ICU, intensive care unit.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4496471&req=5

fig1: Resident self-assessed preparedness prior to the intervention (n = 38), after the intervention (n = 32), and at 9-month follow-up (n = 18). All p < 0.05 except “expressing empathy” at follow-up (p = 0.12). Error bars show standard deviation. ICU, intensive care unit.
Mentions: Self-assessed preparedness significantly increased immediately following the intervention for all items surveyed (Figure 1). Mean score increases on the 5-point Likert scale (1, not well prepared; 3, somewhat prepared; 5, very well prepared; with 2 and 4 corresponding to intermediate values) were significant: giving bad news to a family (0.91, p < 0.01), conducting a family conference (1.0, p < 0.01), expressing empathy (0.58, p < 0.01), discussing treatment options and palliative care with families of critically ill patients (0.66, p = 0.01), responding to families who deny the seriousness of their loved one's illness (0.94, p < 0.01), and discussing discontinuing intensive care treatments (0.67, p < 0.01). The Friedman test revealed significant differences between the 3 assessments. Wilcoxon signed-rank tests demonstrated that scores improved to initial baseline for all items at the 9-month follow-up (Figure 1) except for “expressing empathy” (p = 0.12).

Bottom Line: Results.Conclusion.This study provides evidence that brief simulation-based interventions can produce lasting improvements in residents' confidence to discuss EOL care with family members of patients in the ICU.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA.

ABSTRACT
Introduction. Although residents frequently lead end-of-life (EOL) discussions in the intensive care unit (ICU), training in EOL care during residency has been required only recently, and few educational interventions target EOL communication in the ICU. This study evaluated a simulation-based intervention designed to improve resident EOL communication skills with families in the ICU. Methods. Thirty-four second-year internal medicine residents at a large urban teaching hospital participated in small group sessions with faculty trained in the "VitalTalk" method. A Likert-type scale questionnaire measured self-assessed preparedness before, immediately following, and approximately 9 months after intervention. Data were analyzed using Wilcoxon rank-sum analysis. Results. Self-assessed preparedness significantly improved for all categories surveyed (preintervention mean; postintervention mean; p value), including discussing bad news (3.3; 4.2; p < 0.01), conducting a family conference (3.1; 4.1; p < 0.01), discussing treatment options (3.2; 3.9; p < 0.01), discussing discontinuing ICU treatments (2.9; 3.5; p < 0.01), and expressing empathy (3.9; 4.5; p < 0.01). Improvement persisted at follow-up for all items except "expressing empathy." Residents rated the educational quality highly. Conclusion. This study provides evidence that brief simulation-based interventions can produce lasting improvements in residents' confidence to discuss EOL care with family members of patients in the ICU.

No MeSH data available.