Needs assessment of ethics and communication teaching for neonatal perinatal medicine programs in Canada

Thierry Daboval; Emanuela Ferretti; Ahmed Moussa; Michael van Manen; Gregory P Moore; Ganesh Srinivasan; Alexandru Moldovan; Amisha Agarwal; Susan Albersheim; Canadian Neonatal Ethics and Communication Teaching (CanNECT) working group

doi:10.1093/pch/pxy108

Needs assessment of ethics and communication teaching for neonatal perinatal medicine programs in Canada

Paediatr Child Health. 2019 Jun;24(3):e116-e124. doi: 10.1093/pch/pxy108. Epub 2018 Aug 28.

Authors

Collaborators

Canadian Neonatal Ethics and Communication Teaching (CanNECT) working group:
Kevin Coughlin, Emer Finan, Sophie Nadeau, Simpson David, Connie Williams

Affiliations

¹ Division of Neonatology, Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario.
² Division of Newborn Care, Department of Obstetrics and Gynecology, The Ottawa Hospital - General Campus, Ottawa, Ontario.
³ The University of Ottawa, Ottawa, Ontario.
⁴ Division of Neonatology, Department of Pediatrics, Hôpital Sainte-Justine, University of Montreal, Montreal, Quebec.
⁵ Division of Neonatal-Perinatal Medicine, Department of Pediatrics, John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta.
⁶ Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba.
⁷ Children's Hospital of Eastern Ontario, Student University of Ottawa, Ottawa, Ontario.
⁸ Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario.
⁹ Division of Neonatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia.

Abstract

Objective: To explore ethics education needs in Canadian Neonatal Perinatal Medicine (NPM) training programs.

Methods: A retrospective review of NPM trainees' performance at the National NPM Objective Structured Clinical Examination (OSCE) was undertaken for 2012 to 2017 and two distinct cross-sectional online surveys were carried out. One survey targeted recently graduated neonatologists (RGNs) who completed 2 years' training in a Canadian NPM program between 2010 and 2015; the other survey was sent to Canadian NPM training program directors (PDs). The domains of interest were: perception of education, ethics and communication topics, educational strategies, assessment of trainees' competencies, and barriers to neonatal ethics education.

Results: NPM trainees generally performed less well in stations involving ethics and communication relative to other domains on the National OSCE. Forty-seven RGNs (44.3%) and 12 PDs (92.3%) completed the survey. Over 90% of PDs and RGNs agreed on the importance of training in ethics and communication. Both groups highly valued training on topics related to communication. Preferred teaching strategies were experiential: observation and feedback. PDs mentioned the importance of using validated tools to regularly and formally assess trainees. They recognized challenges in regard to financial resources, physical space, and faculty training in patient-physician communication.

Conclusions: National OSCE results indicate the need to improve neonatal ethics and communication training in Canadian NPM programs. RGNs and PDs identified important topics, as well as teaching and evaluation strategies. These results can be used to develop a training program for ethics and communication in NPM.

Keywords: Assessment; Ethics communication; Medical education; Neonatal-perinatal-medicine; Objective structured clinical examination (OSCE).