Abstract Details

Title Enhancing Skills in Serious Illness Communication in Neurology Residents Using Simulation- A Pilot Study

Topic Research Methodology, ��ɫ��, and History

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-001

Objective Train neurology residents to conduct goals-of-care (GOC) discussions using a structured approach with skills practice and reflection.

Background Many neurologic diseases are incurable, and patients are faced with prognostic uncertainty, progressive decline, and early mortality. As a result, ACGME requires training in serious illness communication for all neurology residents; however, fewer than 50% of programs nationally offer such education. In order to fill this gap, we created a training program for PGY-2 neurology residents to improve their skills, attitudes and behaviors regarding serious illness conversations.

Design/Methods We designed and implemented a 3-hour pilot training for 10 residents utilizing the Serious Illness Conversation Guide (ariadnelabs.org) as a tool for practice. The residents were divided into teams caring for a simulated patient with catastrophic stroke, including: 1) discussing prognosis and exploring goals with actors playing the patient’s family, and 2) navigating treatment options including feeding tube placement, rehabilitation and hospice. A faculty facilitator observed each interaction and called time-outs, allowing residents to self-assess and obtain feedback from actors and peer residents. Following the simulation, residents debriefed as a group to identify take-home points to guide their clinical practice, as well as reflect on their own emotions, self-care and sense of purpose in medicine.

Results Eight out of 10 residents completed pre-surveys and all residents submitted post-session evaluations. Faculty facilitators and actors found residents had difficulty dealing with strong emotions, displaying empathy, and maintaining silence. All residents reported the simulation was a helpful, rewarding experience and improved their abilities to discuss GOC, address prognosis, and explore end-of-life issues with patients.

Conclusions Our small pilot project demonstrates an innovative model of individual and group-based experiential learning that also provides opportunity for reflection on relationship-based care, professionalism and clinician resiliency.

Authors/Disclosures
Marcey L. Osgood, DO PRESENTER	Dr. Osgood has nothing to disclose.
Brian Silver, MD, FAAN (UMass Memorial Medical Center)	Dr. Silver has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Various legal firms. Dr. Silver has received intellectual property interests from a discovery or technology relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Women's Health Initiative. Dr. Silver has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Best Doctors, Inc./Teladoc, Inc.. Dr. Silver has a non-compensated relationship as a Consultant with ABPN that is relevant to AAN interests or activities. Dr. Silver has a non-compensated relationship as a Member, Regional Board of Directors with American Heart Association that is relevant to AAN interests or activities.
	No disclosure on file
	No disclosure on file

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