Duncan Ellen L, Agnant Joanne M, Sagalowsky Selin T
From the Departments of Emergency Medicine and Pediatrics (E.L.D.), New York University Langone Health, New York, NY; Departments of Emergency Medicine and Pediatrics (J.M.A.), New York University Langone Health, New York, NY; New York Simulation Center for Health Sciences (J.M.A.), New York, NY; and Departments of Emergency Medicine and Pediatrics (S.T.S.), New York University Langone Health.
Simul Healthc. 2025 Jun 24. doi: 10.1097/SIH.0000000000000866.
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.
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.
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.
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.
绝大多数家庭都希望在儿科复苏过程中在场，而他们的在场有诸多益处。然而，关于如何教授和评估以患者及家庭为中心的关键沟通行为，几乎没有相关证据。我们的目标是应用改良的德尔菲法来开发和完善一种基于模拟的评估工具，该工具聚焦于医疗服务提供者在儿科医疗复苏期间为患者和家庭提供情感支持的关键行为。
我们通过文献综述、与本机构家庭及青年咨询委员会的焦点小组讨论以及对现有的基于模拟的沟通评估工具进行改编，确定了4个行为领域和14个子领域。由9名全国专家组成的小组对候选行为进行了多轮迭代修订和纳入评级，我们计算了每个子领域的平均批准评级（1 = 不纳入；2 = 修改后纳入；3 = 原样纳入）。
专家们进行了5轮迭代修订。没有候选行为被淘汰，并且在“尊重与重视”领域增加了1个行为（“选择退出”）。最终工具的语言达成了近乎完美的共识，除1个子领域（“介绍”）外，所有子领域的平均批准得分均为3.0，“介绍”子领域因小的语法编辑平均得分为2.83；这些都纳入了最终评估工具。
我们通过改良的德尔菲法，基于文献综述、关键利益相关者的意见以及全国专家的共识，创建了一种新颖的模拟评估工具。我们最终的模拟评估工具以行为为锚定，可以由模拟参与者或观察者完成，并且可能有助于对参与儿科复苏的医疗团队进行以患者及家庭为中心的沟通教育。
