Simulated parents: developing paediatric trainees' skills in giving bad news

J Paediatr Child Health. 2009 Mar;45(3):133-8. doi: 10.1111/j.1440-1754.2009.01440.x.

Abstract

Aim: In curriculum documents for medicine in undergraduate, post-graduate and continuing professional development, there is now a focus on communication skills. The challenges are to place communication skills in the crowded curriculum and then to construct and sustain a programme that uses an evidence-based approach to the teaching and learning of communication skills. For 6 years, we have conducted a programme that involves simulated parents supporting junior medical staff to refine their skills in communication, particularly in giving parents bad news. The aim of our study was to obtain a better understanding of the trainees' experiences of the programme.

Methods: Nine junior residents individually worked through two scenarios and received feedback from the simulated parent. They gave bad news to a simulated parent/actor who then gave feedback. A recording of the simulation was provided for discussion with a designated colleague at an arranged time. The tapes were then separately appraised by two independent raters - another actor and a paediatrician. Brief written reports and conducted semi-structured interviews provided more insights into the trainees' experience of the simulation. Other participating medical/medical education staff were interviewed about the simulation programme.

Results: Five themes emerged from the qualitative data: timeliness, emotional safety, the complexity of communication, practical usefulness and the challenge of effecting change. In addition, the ratings of the videos helped to clarify those 'parent-centred' communication skills that trainees may neglect in difficult conversations: 'ask about support', 'encourage the parent to ask questions' and 'repeat key messages'.

Conclusion: The evaluation highlighted the value of an early-career experiential programme to highlight the importance of communication skills in post-graduate paediatrics practice.

MeSH terms

  • Communication
  • Education
  • Evidence-Based Medicine
  • Humans
  • Interviews as Topic
  • Medical Staff, Hospital / education*
  • Parents
  • Pediatrics*
  • Professional Competence
  • Professional-Family Relations*
  • Teaching
  • Truth Disclosure*