To pilot cases of Brain Death/Death by Neurologic Criteria (BD/DNC) for a novel simulation-based mastery learning curriculum, evaluating feasibility of implementation across high- and low-fidelity simulation environments and effects on participants’ confidence in performing BD/DNC.

BD/DNC determination requires uniform mastery, yet many trainees have limited clinical exposure and receive inconsistent training, compounded by variability in institutional protocols.

We developed three cases simulating common challenges to BD/DNC determination. Cases were piloted across six American academic institutions over a six-month period, using the level of simulation fidelity available at each site. Participants completed one of three cases, received debriefing, and completed a pre/post-survey assessing confidence via Likert scale (1-not confident to 5-very confident) across four domains: “Set up and Counseling,” “Prerequisites,” “Neurological Examination,” and “Apnea Test and BD/DNC Declaration.” Pre vs. post composite domain scores were compared using Wilcoxon signed-rank test. Domain-specific score changes were compared between high- and low-fidelity groups using Mann-Whitney U test.

This pilot demonstrated feasibility of implementing a BD/DNC simulation curriculum across institutions with varying resources. Lessons learned informed refinements to case design and implementation for a simulation-based mastery learning curriculum.