735 - Implementation and Impact of a Resident-Led Communication Curriculum for Pediatric Residents

Publication Number: 3711.735

Rory Bade, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Heidi Kloster, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Amy Trowbridge, University of Washington School of Medicine, Seattle, WA, United States; Taylor R. House, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States

Background: High-quality serious illness communication - iterative, empathic discussions that integrate individual values - is a cornerstone of pediatric medicine and a core competency for trainees. Few communication curricula exist in pediatrics, and those available often lack the critical perspectives of residents. As a result, pediatric residents report few opportunities to develop these skills and lack confidence to conduct high-quality discussions. We adapted VitalTalk communication frameworks to develop a serious illness communication curriculum designed for and facilitated by pediatric residents.

Objective: Our objective was to evaluate the acceptability and impact of this resident-led curriculum.

Design/Methods: The 3-hour curriculum utilized in-person didactics, simulated cases, and small group discussion focused on communication as a procedural skill including identifying and responding to emotions, common communication pitfalls, and sharing serious news. A VitalTalk-trained resident leader delivered didactics, ran simulations, and led small group discussions with VitalTalk-trained faculty oversight. Simulated cases were based on first-hand resident encounters. The curriculum was delivered to a single residency class. Participants completed a survey with 5-point Likert-scale and free-text responses to assess curriculum utility and resident confidence. Data were summarized descriptively, and pre/post-curriculum responses were assessed with paired t-tests.

Results: Thirteen PGY-2 residents completed the survey (100% response). Residents reported high utility and satisfaction, giving high ratings for the curriculum's overall value (Mean 4.80.4 SD) and indicating they would highly recommend the course (Mean 4.90.3 SD). Peer feedback was rated as critical for skill development (Mean 4.90.3 SD). Resident confidence significantly increased across all queried communication skills (Figure). Free-text responses highlighted that resident facilitation and conducting the session among a single PGY class were key to "preventing hierarchies" and creating psychological safety.

Conclusion(s): Our evidence-based, resident-led serious illness communication curriculum was highly acceptable and improved resident communication self-efficacy. The curriculum's design - developed with and led by residents - was essential for fostering a safe environment for effective skills practice. Future work will focus on developing a sustainable pipeline for resident facilitators, implementing across other residency classes, and assessing long-term skill retention.

Changes in Residents' Self-Assessed Communication Skills
Following the workshop, residents were asked to evaluate themselves on several communication skills before and after curriculum participation using a 5-point Likert scale. Paired t-tests were used to assess for statistical significance and error bars represent standard deviation of the population. Residents demonstrated statistically significant improvement in all queried skills - creating an environment conducive to delivering serious news, assessing caregiver understanding, explaining medical information, identifying and responding to emotion cues, and delivering serious news. *=p-value <.05; **=p-value <.01.