Development of a Tool to Evaluate Emotional Support for Patients and Families During Simulated Pediatric Resuscitations: A Modified Delphi Study.

BACKGROUND

Families overwhelmingly want to be present during pediatric resuscitations, and their presence offers myriad benefits. However, there is little evidence on how to teach and assess key patient- and family-centered communication behaviors. Our objective was to apply a modified Delphi methodology to develop and refine a simulation-based assessment tool focusing on crucial behaviors for healthcare providers providing emotional support to patients and families during pediatric medical resuscitations.

METHODS

We identified 4 behavioral domains and 14 subdomains through a literature review, focus groups with our institution's Family and Youth Advisory Councils, and adaptation of existing simulation-based communication assessment tools. A panel of 9 national experts conducted rounds of iterative revision and rating of candidate behaviors for inclusion, and we calculated mean approval ratings (1 = Do not include; 2 = Include with modifications; 3 = Include as is) for each subdomain.

RESULTS

Experts engaged in 5 iterative rounds of revision. None of the candidate behaviors were eliminated, and 1 ("Option to step out") was added to the "Respect and Value" domain. There was near-perfect consensus on the language of the final tool, with mean approval scores of 3.0 for all but 1 subdomain ("Introductions"), which had a mean score of 2.83 for minor grammatical edits; these were incorporated in the final assessment tool.

CONCLUSIONS

We created a novel simulation assessment tool based on a literature review, key stakeholder input, and a consensus of national experts through a modified Delphi method. Our final simulation assessment tool is behaviorally anchored, can be completed by a simulated participant or observer, and may serve to educate healthcare teams engaged in pediatric resuscitations regarding patient- and family-centered communication.