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Using standardized family members to teach communication skills and ethical principles to critical care trainees*

Downar, James MD, MHSc, FRCPC; Knickle, Kerry LLM; Granton, John T. MD, FRCPC; Hawryluck, Laura MD, MSc, FRCPC

Critical Care Medicine:
doi: 10.1097/CCM.0b013e31824e0fb7
Clinical Investigations
Abstract

Objective: We sought to determine the effectiveness of standardized family members for improving communication skills and ethical and legal knowledge of senior intensive care unit trainees.

Design: Multimodal evaluation of mixed-methods educational intervention.

Setting: Postgraduate critical care medicine academic program.

Subjects: Postgraduate subspecialty critical care medicine trainees.

Intervention: Communication workshop featuring a short didactic session and four simulated family meetings using trained professionals as standardized family members.

Measurements: Ethical and legal knowledge and comfort with communication (before and after the workshop) and communication skill (during the workshop).

Main Results: Fifty-one postgraduate critical care medicine subspecialty trainees participated in the workshop over a 5-yr period. Ethical and legal knowledge and comfort scores improved significantly among trainees who participated in the workshop. Ninety percent of trainees felt that the workshop had met or exceeded their expectations and would recommend it to other trainees. Ninety-eight percent of trainees felt that the workshop had met the highest priority learning objectives they identified. Communication scores showed a trend towards improvement over the course of the workshop, although the improvements were not significant. Participants reflecting on the workshop >1 yr later overwhelmingly felt that it had prepared them for real communication challenges in training and practice.

Conclusions: This workshop was effective for improving ethical and legal knowledge and comfort with communication among critical care medicine trainees. Participants overwhelmingly felt that it had met their learning needs and that it was an effective teaching tool that had prepared them for real communication challenges in training and practice. It could be used in a variety of contexts to address an often-neglected area of education.

Author Information

From the Faculty of Medicine (JD), Standardized Patient Program (KK), and Division of Critical Care (JTG, LH), University of Toronto, Ontario, Canada.

*See also p. 1978.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (http://journals.lww.com/ccmjournal).

Dr. Downar, Mr. Knickle, and Dr. Hawryluck were involved in study conception and design, delivery of intervention, data collection, analysis, and manuscript preparation and revision. Dr. Granton was involved in study design, delivery of intervention, and manuscript preparation and revision.

Financial Support provided by the Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada

The authors have not disclosed any potential conflicts of interest.

For information regarding this article, E-mail: james.downar@utoronto.ca

© 2012 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins