591 - A Pilot Multimodal Structured Communication Curriculum for Neonatology Fellows Utilizing Simulation in the Delivery of Difficult News

Poster Number: 591
Publication Number: 591.118

Joshua Erickson, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Ogechukwu Menkiti, Drexel University College of Medicine, cherry hill, NJ, United States; Swosti Joshi, St. Christopher's Hospital for Children, Phialdelphia, PA, United States; Kheyandra D. Lewis, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Vilmaris Quinones Cardona, Drexel University College of Medicine/St Christopher’s Hospital for Children, Philadelphia, PA, United States

Background: Educational curricula centered on communication skills in the delivery of difficult news within neonatology is lacking. Traditionally, these skills are acquired by observing encounters during training in an apprenticeship model, which may vary within and between institutions. Simulation has been shown to be an effective tool in teaching communication strategies for the delivery of difficult news in several settings.

Objective: To evaluate the effectiveness of a multimodal communication curriculum among neonatology fellows in perceived comfort and acquisition of skills to deliver difficult news.

Design/Methods: A single-center prospective pilot study including 16 neonatal-perinatal medicine fellows was conducted from March 2020 and is ongoing through May 2022. Baseline and ongoing evaluations of subjects include pre- and post-standardized patient (SP) encounter surveys to assess perceived comfort in delivering difficult news as well as objective evaluation of video recordings by a blinded simulation specialist utilizing the Kalamazoo Communication Effectiveness Tool (KCET). A multimodal curriculum consisting of four didactic sessions, two simulation sessions, and two video-recorded SP encounters was implemented and continued annually. Baseline data and yearly performance were compared between post-graduate year levels using one-way ANOVA. Individual comfort data and KCET performance were also analyzed longitudinally with paired Student’s t-test.

Results: Baseline assessments were completed on 12 fellows prior to implementation of the study curriculum with post-intervention data collected on seven thus far. Despite varying years of training, perceived comfort and KCET performance was comparable between training levels at baseline except for “understanding family perspective” (higher among 1st year fellows). There was statistically significant improvement in average total scores relating to comfort in delivering difficult news after 1 year of curriculum exposure (Table 1). There was statistically significant improvement in only one of the variables, “reaching agreement”, of KCET performance thus far (Table 2).Conclusion(s): A pilot multimodal communication curriculum has the potential to improve perceived comfort among neonatology fellows in delivering difficult news. Continued assessments are needed to determine the effectiveness of this curriculum in improving objective communication skills.
Table 1Subjective variables related to comfort in delivering difficult news
Table 2Variables of Kalamazoo Communication Effectiveness Tool (KCET) performance