Department of Surgery, Temple University Hospital, Philadelphia, Pennsylvania.
Department of Surgery, Temple University Hospital, Philadelphia, Pennsylvania.
J Surg Educ. 2022 Jan-Feb;79(1):198-205. doi: 10.1016/j.jsurg.2021.08.018. Epub 2021 Sep 8.
Residents often are involved in discussions with families regarding brain death/death by neurologic criteria (BD/DNC); however, they receive no standardized training on this topic. We hypothesized that residents are uncomfortable with explaining BD/DNC and that formal didactic and simulated training will improve residents' comfort and skill in discussions surrounding BD/DNC.
We partnered with our organ procurement organization (OPO) to create an educational program regarding BD/DNC consisting of a didactic component, and role-play scenarios with immediate individualized feedback. Residents completed pre- and post-training surveys.
This study included participants from 16 academic and community institutions across New Jersey, Pennsylvania, and Delaware that are within our OPO's region.
Subjects were recruited using convenience sampling based on the institution and training programs' willingness to participate. A total of 1422 residents at participated in the training from 2009 to 2020. 1389 (97.7%) participants competed the pre-intervention survey, while 1361 (95.7%) completed the post-intervention survey.
Prior to the training, only 56% of residents correctly identified BD/DNC as synonymous with death. Additionally, 40% of residents had explained BD/DNC to families at least once, but 41% of residents reported never having been taught how to do so. The biggest fear reported in discussing BD/DNC with families was being uncomfortable in explaining BD/DNC (48%). After participating in the training, 99% of residents understood the definition of BD/DNC and 92% of residents felt comfortable discussing BD/DNC with families.
Participation in a standardized curriculum improves residents' understanding of BD/DNC and their comfort in discussing BD/DNC with families.
住院医师经常参与与家属关于脑死亡/神经标准死亡（BD/DNC）的讨论；然而，他们没有接受过关于这个主题的标准化培训。我们假设住院医师对解释 BD/DNC 感到不舒服，并且正式的教学和模拟培训将提高住院医师在围绕 BD/DNC 的讨论中的舒适度和技能。
我们与我们的器官采购组织（OPO）合作，创建了一个关于 BD/DNC 的教育计划，该计划包括一个教学部分和角色扮演场景，以及即时的个性化反馈。住院医师在培训前后完成了调查。
这项研究包括来自新泽西州、宾夕法尼亚州和特拉华州的 16 个学术和社区机构的参与者，这些机构都在我们 OPO 的区域内。
根据机构和培训计划参与的意愿，采用方便抽样法招募受试者。共有 1422 名住院医师参加了 2009 年至 2020 年的培训。1389 名（97.7%）参与者在干预前完成了调查，而 1361 名（95.7%）参与者在干预后完成了调查。
在培训之前，只有 56%的住院医师正确地将 BD/DNC 识别为等同于死亡。此外，40%的住院医师至少向家属解释过一次 BD/DNC，但 41%的住院医师报告从未接受过如何进行解释的培训。在与家属讨论 BD/DNC 时报告的最大恐惧是解释 BD/DNC 时感到不舒服（48%）。参加培训后，99%的住院医师理解了 BD/DNC 的定义，92%的住院医师对与家属讨论 BD/DNC 感到舒适。
参与标准化课程可以提高住院医师对 BD/DNC 的理解和与家属讨论 BD/DNC 的舒适度。
