P3B012: A Mixed Methods Curriculum to Improve Pediatric Residents' Communication Skills Delivering Serious News

Background: Navigating difficult conversations is an important skill that all physicians will utilize in their career. An ideal communication training curriculum has yet to be established and should allow for skill acquisition, retention, and translation to patient care. We studied a novel mixed-methods curriculum that combined role-play, didactic education, and a procedure card with language prompts to improve pediatric residents’ skills in communicating difficult news and help to retain these skills.

Methods: All second-year pediatric residents at our program were eligible to enroll in the study. Enrolled participants first completed a survey eliciting self-efficacy navigating difficult conversations. Additionally, they took part in an observed simulation delivering difficult news to a standardized patient to establish baseline data; communication skills were evaluated by study investigators.
A month later, investigators taught an interactive educational session to all participants. This session, based on a previously validated communication framework, VitalTalk, covered skills to effectively deliver serious news. Participants were also introduced to a procedure card that highlighted this communication framework. Participants were asked to use this procedure card as a just-in-time reference prior to difficult conversations with actual patients and families over the next six months.
Following this period, participants completed a second self-efficacy survey and engaged in another simulation session delivering difficult news; this session was evaluated again by study investigators.

Results: Twenty-six residents enrolled in the study; 21/26 (81%) completed all phases. There was a significant improvement in participants’ subjective assessment of their ability to navigate difficult conversations (Table 1). Additionally, there was a significant improvement in investigators’ assessment of participants’ communication skills (Table 2).

Conclusion: This mixed method curriculum utilizing didactics, role-play, and a procedure card resulted in significantly improved subjective and objective communication skills in pediatric residents and allowed these skills to be retained over time.