Abstract Details

Title Development and Evaluation of a Child Neurology Residency Curriculum for Delivering Bad News

Topic Research Methodology, �鶹��ýӳ��, and History

Presentation(s) P7 - Poster Session 7 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-006

Objective To develop and evaluate a curriculum on delivering bad news (BN) utilizing the SPIKES protocol for child neurology residents (CNR) that shows long-term retention of skills in real clinical settings.

Background Delivering BN is a core competency and essential skill for all residencies. Up to 20% of neurology residencies have no curriculum. Most educational interventions are didactic or use role-play to assess confidence performing this skill without evaluation in clinical settings. The SPIKES protocol (Setting, Perception, Invitation, Knowledge, Empathy, Strategy/Summary) outlines six evidence-based steps for communicating BN. How well CNR can incorporate SPIKES in delivering BN in real clinical settings has not been evaluated.

Design/Methods We created a skills checklist based on the SPIKES protocol for CNR, dividing them into 20 total and 10 core skills. Faculty observed CNR (n=7) delivering BN to families and completed pre-intervention checklists for baseline data. CNR were then trained in SPIKES during a two-hour session using didactic and coached role-play techniques. CNR will be evaluated by faculty during the year as they deliver BN in clinical settings.

Results Pre-intervention checklists (n=17) show CNR used a mean of 9/20 steps (45%) and 5.6/10 core steps (56%) of SPIKES. While 6/7 (85%) CNR reported receiving training for delivering BN during medical school, 4/7 (57%) reported having no current framework to structure these conversations. All CNR (n=7) reported comfort communicating medical information and discomfort responding to patient/family emotions, with improved confidence using SPIKES following the training session. Post-intervention evaluation is ongoing.

Conclusions This is the first evaluation of a curriculum for CNR focused on delivering BN. We identified resident discomfort with patient/family emotions despite most receiving training in medical school, and improved comfort with the SPIKES protocol after training. Ongoing evaluation may demonstrate a reproducible method for teaching and evaluating this core communication skill for residents in any residency program.

Authors/Disclosures
Jan A. Martin, MD (University of Washington/Seattle Children's Hospital) PRESENTER	Dr. Martin has nothing to disclose.
	No disclosure on file
Craig A. Press, MD, PhD (Children's Hospital of Philadelphia)	Dr. Press has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Marinus Pharmaceuticals. Dr. Press has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Law Firms. Dr. Press has received research support from Marinus Pharmaceuticals. Dr. Press has received research support from Pediatric Epilepsy Research Foundation. Dr. Press has received research support from NIH.
Ricka Messer, MD (Children'S Hospital Colorado)	The institution of Dr. Messer has received research support from Ultragenyx Pharmaceutical Inc. Dr. Messer has a non-compensated relationship as a Chair of the Pediatric Neurology Specialty Steering Board with Epic that is relevant to �鶹��ýӳ�� interests or activities. Dr. Messer has a non-compensated relationship as a Member of the �鶹��ýӳ�� Quality Informatics Subcommittee with �鶹��ýӳ�� that is relevant to �鶹��ýӳ�� interests or activities.
Megan M. Barry, MD (Lurie Children's Hospital of Chicago)	Dr. Barry has nothing to disclose.
	No disclosure on file
	No disclosure on file