The educational intervention "GRIEV_ING" improves the death notification skills of residents

Acad Emerg Med. 2005 Apr;12(4):296-301. doi: 10.1197/j.aem.2004.12.008.


Background: Death notification is a common, difficult, and emotionally laden communication for emergency physicians. Teaching emergency medicine residents the skills for success in this communication is an important focus for educators. To accomplish this task, educators need practical, proven teaching and assessment tools focused on death notification skills.

Objectives: To test the hypothesis that a teaching module, based on the mnemonic "GRIEV_ING," could improve resident confidence, competency, and communication skills when delivering a death notification.

Methods: The GRIEV_ING intervention consisted of a two-hour educational session composed of small-group, role-play, and didactic experiences. The authors used a pre-post-retention repeated-measures design to test their hypothesis immediately following and three months after training. For each assessment cycle, three quantitative measures were collected: self-confidence, relationship-communication, and competency. Relationship-communication and competency scores were collected during simulated survivor encounters.

Results: Complete data for 20 residents were obtained. Significant improvements were noted in resident confidence scores at the pre-post (F = 16.7, p <0.0001) and pre-retention (F = 14.0, p = 0.001) comparisons. Likewise, significant improvements were noted in resident competence scores at the pre-post (F = 4.7, p = 0.04) and pre-retention (F = 8.8, p = 0.008) comparisons. Resident relationship-communication scores were uniformly high, and there was no significant change in this score across study intervals.

Conclusions: This study demonstrates that a defined educational intervention focused on the GRIEV_ING mnemonic can improve physician confidence and competence in death notification.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Communication*
  • Emergency Medicine / education
  • Humans
  • Internship and Residency*
  • Interpersonal Relations*
  • Professional-Family Relations
  • Teaching / methods