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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 satisfaction with intervention (n = 32; 1, Poor; 2, Fair; 3, Good; 4, Very Good; 5, Excellent). Error bars show standard deviation. ICU, intensive care unit.
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fig2: Resident satisfaction with intervention (n = 32; 1, Poor; 2, Fair; 3, Good; 4, Very Good; 5, Excellent). Error bars show standard deviation. ICU, intensive care unit.

Mentions: The intervention was favorably evaluated by the residents, including the utility of the interactive didactics, use of actors for skill practice, and readability and utility of the presession modules (Figure 2). Additionally, more than 90% of residents “strongly agreed” that this training should be required for all internal medicine residents.


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 satisfaction with intervention (n = 32; 1, Poor; 2, Fair; 3, Good; 4, Very Good; 5, Excellent). Error bars show standard deviation. ICU, intensive care unit.
© Copyright Policy
Related In: Results  -  Collection

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

fig2: Resident satisfaction with intervention (n = 32; 1, Poor; 2, Fair; 3, Good; 4, Very Good; 5, Excellent). Error bars show standard deviation. ICU, intensive care unit.
Mentions: The intervention was favorably evaluated by the residents, including the utility of the interactive didactics, use of actors for skill practice, and readability and utility of the presession modules (Figure 2). Additionally, more than 90% of residents “strongly agreed” that this training should be required for all internal medicine residents.

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.