Division of Newborn Medicine, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Geriatrics and Palliative Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Am J Hosp Palliat Care. 2024 Jun;41(6):651-657. doi: 10.1177/10499091231198507. Epub 2023 Aug 25.
Despite proven benefit, pediatric subspecialists often have not been offered formal serious illness communication skills training. We sought to: 1) develop and evaluate the impact of a communication skills course, based on the VitalTalk framework, on Neonatal Intensive Care Unit (NICU) clinicians; 2) evaluate provider comfort with key serious illness communication skills and frequency of use of those skills, before and after "NeoTalk" and; 3) explore differences and similarities between adult and pediatric serious illness communication skills courses.
We developed a NICU specific communication skills course and surveyed course participants to evaluate comfort with key communication skills before and after course participation, and frequency of use of key skills before and 2 months after our course. Wilcoxon signed rank tests and Kruskal-Wallis tests were performed to compare participant responses across time points.
34 providers completed NeoTalk training. Complete pre- and post-course data was available for 29 participants. Participants reported increased comfort with skills including 'sharing difficult news' ( = .018), and 'responding to emotion' ( = .002). Participants did not report increased frequency in using target skills 2 months after training.
A multi-disciplinary cohort of NICU providers endorsed increased confidence in key communication skills but not increased skill application 2-months post-course completion. While a single course can successfully teach skills, additional exposure may be necessary to build new communication habits. Our experience developing NeoTalk helped elucidate some of the ways in which conversations about seriously ill infants may be different from conversations about seriously ill adults.
尽管已证实有益,但儿科专家通常未接受正式的重病沟通技巧培训。我们旨在:1)基于 VitalTalk 框架,开发和评估针对新生儿重症监护病房(NICU)临床医生的沟通技巧课程的影响;2)评估提供者在接受“NeoTalk”前后对关键重病沟通技巧的舒适度以及使用这些技巧的频率;3)探索成人和儿科重病沟通技巧课程之间的差异和相似之处。
我们开发了一种特定于 NICU 的沟通技巧课程,并对课程参与者进行了调查,以评估他们在参加课程前后对关键沟通技巧的舒适度,以及在参加我们的课程之前和 2 个月后使用关键技巧的频率。Wilcoxon 符号秩检验和 Kruskal-Wallis 检验用于比较参与者在不同时间点的反应。
34 名提供者完成了 NeoTalk 培训。29 名参与者提供了完整的课前和课后数据。参与者报告说,他们对包括“分享困难的消息”( =.018)和“回应情绪”( =.002)在内的技能的舒适度有所提高。参与者在培训后 2 个月并未报告目标技能使用频率增加。
多学科 NICU 提供者群体对关键沟通技巧的信心增强,但在课程完成后 2 个月,技能应用并未增加。虽然单一课程可以成功教授技能,但可能需要更多的接触来建立新的沟通习惯。我们在开发 NeoTalk 方面的经验阐明了一些关于重病婴儿的对话可能与关于重病成人的对话不同的方式。