Rehearsal simulation for antenatal consults

Abstract

Background: Rehearsal simulations are patient-specific case-matched tasks performed immediately prior to the actual task, with the objective of improving performance.
 Objective: How does rehearsal simulation for antenatal consults impact how residents learn to engage in difficult conversations with families?
 Study Design: Residents in the NICU performed case-matched video recorded rehearsal simulations, followed by actual antenatal consults. The purpose of antenatal consults is to prepare parents expecting a complication with their baby before birth. Questionnaires assessed changes in resident confidence and self-assessment of communication skills. Residents were interviewed for qualitative data to explore the overall impact of rehearsal simulation on their learning and performance.
 Results: Thirteen residents participated. Rehearsal simulation improved confidence with a more organized approach of medical content and better communication techniques, allowing for a shift of focus from a checklist approach to building rapport and displaying empathy.
 Conclusions: While rehearsal simulation did not prepare residents for unexpected parent responses, trainees’ increased confidence with medical content organization and communication techniques created space for reflection-in-action and compassionate approaches.

Set Up to Fail? Barriers Impeding Resident Communication Training in Neonatal Intensive Care Units

“…18,30 In the meantime, given the valid concerns raised by participants about parent well-being, carefully planned teachable moments can reduce learner stress and improve confidence, promoting a shift in focus from a checklist approach to one that is improvisational and aimed at building rapport and enacting empathy. 31,32 Debriefing about difficult conversations will also support active coaching dialogues for next steps in learning. [33][34][35] This is especially true when MDs are willing to verbalize and make tacit processes explicit, highlighting nuances and ambiguity in navigating difficult conversations.…”