Improving Communication Competencies in Neonatology: A Multimodal Simulation-Based Palliative Care Workshop.

Abstract

BackgroundEffective communication between providers and parents is fundamental in critical care provision. Particularly when discussing goals of care and delivering bad news, which is often complicated by differing values and beliefs. Many trainees lack formal education in communication skills for end-of-life care. Implementing a formal curriculum may improve physician-patient relationships, parents' mental health, and overall patient care.ObjectiveTo assess the impact of an integrative multimodal simulation-based palliative care workshop experience combining simulated complex medical cases with challenging conversations to mirror real life scenarios on clinicians' knowledge, attitudes and communication skills.Study DesignThree simulation scenarios were conducted, combining medical management of a high-fidelity mannequin with challenging conversations with actors portraying as parents. Changes in participants' attitudes, knowledge, and communication skills were assessed pre- and post-intervention using both subjective and objective measures. Data was analyzed using chi-square tests, and paired-sample t-tests.ResultsTwenty-two participants completed the scenarios with a significant improvement in verbal and non-verbal communication skills, between the first and second case. There was improvement in participants' competency in delivering bad news, discussing death with parents, and disclosing medical errors.ConclusionAn integrative palliative care workshop combining high-fidelity medical management with concurrent emotionally challenging conversations improved clinicians' knowledge, attitudes, and communication skills. This real-time approach reflects the complexity of critical care and supports its incorporation into training to enhance clinician preparedness for simultaneous medical and communication demands during intense, life-threatening clinical scenarios.