Communicating Difficult News: Comparing Skills Retention in Pediatric Residents

Introduction: Delivering challenging news is an important but often daunting part of pediatric residency. Simulation-based education has been proven to be an effective method to teach this vital communication skill. There is evidence that pediatric residents report increased confidence in communication skills after participating in communication education with a simulation component. The aim of this study is to compare retention of communication skills over a 3-6 month time period between two common simulation modalities: traditional vs rapid cycle deliberate practice (RCDP).


Methods: Participants will include Pediatric, Pediatric Genetics, Pediatric Neurology, and Medicine Pediatric Residents during their PICU rotation. Participants will receive a chalk talk on the importance of three key communication skills. These skills include: use of a headline statement, use of NURSE statements in response to emotion, and therapeutic silence. Following this education, they will individually participate in a simulation case designed to be appropriate to the level of training and broad enough to be applicable to all pediatrics residents. The case involves delivering the news to a single mother that her infant has bacterial meningitis. A specifically communication-trained standardized patient will be used and participants will be split into a RCDP group and a traditional simulation group. In the 3-6 months following the initial simulation, each participant will participate in a follow-up traditional simulation to evaluate skills retention using a Likert scale. The encounter will be recorded and reviewed by the lead investigator and an independent reviewer. Participant self-evaluation and perceived usefulness of the simulation will also be collected at both time points.


Results: As this study is ongoing, results are currently pending. The follow-up simulation cases will begin in August 2025 as all participants have been enrolled. A total of 20 residents completed the didactic session and initial simulation. Follow up simulation cases will be complete by January 2026.


Conclusions: Preliminary findings from the initial phase suggest that residents find didactic lecture followed by simulation to be a useful learning strategy. Participants particularly appreciate the real-time feedback associated with RCDP simulation.