Objective
Effective communication among providers, families, and patients is essential in critical care, but is often inadequate in the pediatric ICU. To address the lack of communication education PCCM fellows receive, the Children’s Hospital of Pittsburgh PICU developed a simulation-based communication course, Pediatric Critical Care Communication Course (PC3). PCCM trainees have limited prior training in communication and will have increased confidence in their communication skills after participating in the PC3 course.
Design
PC3 is a 3-day course taken once during fellowship featuring simulation with actors portraying family members. Prior to and after the course, fellows complete an anonymous survey asking about 1) prior instruction in communication 2) preparedness for difficult conversations, 3) attitudes about end-of-life care, and 4) course satisfaction. We compared pre- and post-course surveys using paired student’s t-test.
Main Results
Most of the 38 fellows who participated over 4 years had no prior communication training in conducting a care conference (70%), providing bad news (57%), or discussing end of life options (75%). Across all four iterations of the course, fellows after the course reported increased confidence across many topics of communication, including giving bad news, conducting a family conference, eliciting both a family’s emotional reaction to their child’s illness and their concerns at the end of a child’s life, discussing a child’s code status, and discussing religious issues. Specifically, fellows in 2014 reported significant increases in self-perceived preparedness to provide empathic communication to families regarding many aspects of discussing critical care, end of life care and religious issues with patients’ families (p<0.05). The majority (90%) of fellows recommended that the course be required in PCCM fellowship.
Conclusions
The PC3 course increased fellow confidence in having difficult discussions common in the PICU. Fellows highly recommend it as part of PICU education. Further work should focus on the course’s impact on family satisfaction with fellow communication.