The following is a summary of “Curriculum Innovations: Enhancing Skills in Serious Illness Communication in Neurology Residents Using Simulation: A Pilot Study,” published in the August 2024 issue of Neurology by Osgood et al.
Early mortality, prognostic uncertainty, and progressive decline are usually faced in patients with acute ischemic stroke (AIS), and many neurologists report a lack of education and supportive care.
Researchers started a retrospective study to develop a simulation-based curriculum to enhance residents’ confidence and skills in conducting late-stage goals of care (GOC) conversations.
They organized a 3-hour interactive simulation and debriefing session to enhance skills to deliver difficult news, discuss prognosis, explore goals, navigate treatment options, and discuss end-of-life care, including hospice. Each interaction was observed to provide feedback and self-assessment, thereby ensuring the effectiveness of the training. Debriefing was conducted to reinforce critical points, emotions, self-care, and a sense of purpose in medicine.
The results showed that 26 neurology residents completed an anonymous survey to self-assess confidence and comfort in GOC conversations. The data reported 50% confidence in conducting GOC discussions, whereas 42% reported adequate prior training. After the session, 90% reported that the training was relevant, and 15 residents discovered an improvement in comfort with prognosis, hospice, and early GOC discussions.
They concluded that late-stage GOC conversations, building literature supporting structured program and simulation components, improved the ability to have GOC conversations with patients.
Source: neurology.org/doi/10.1212/NE9.0000000000200140
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