TOP 4 - Understanding the Impact of Longitudinal Communication Training for Pediatric Residents

Publication Number: 1764.TOP 4

Anna Henricks, University of Texas Southwestern Medical School, Dallas, TX, United States; Megan L. Shea, University of Texas Southwestern Medical School, Dallas, TX, United States; Katherine Maddox, Imagine Pediatrics, Somerville, MA, United States; Lauren M. Williams, University of Texas Southwestern Medical School, Dallas, TX, United States

Background: Communication skills are integral to the physician-patient relationship. Despite calls for formal curriculum during training, many clinicians report little to none. If offered, most education is a single session despite data that serial ones are more effective. Few focus on pediatrics, which is unique due to family dynamics with surrogate decision-making and more prognostic uncertainty. Often, pediatric communication training focuses on subspecialists’ needs rather than those necessary for all pediatricians.
VitalTalk is an evidence-based rapid cycle deliberate simulation-based training program that improves provider comfort and skills with serious illness communication. It is widely utilized throughout medical education with growing success. Our institution implemented annual VitalTalk training in 2022, mandatory for all pediatric residents. The 2025 graduating class is the first cohort to undergo annual training each year of residency.

Objective: We aim to evaluate the efficacy of serial VitalTalk training on pediatric residents’ comfort level and knowledge when discussing serious illness and goal-concordant care.

Design/Methods: Our study occurred at a large quaternary children’s hospital with 31-47 residents per class. Sessions occurred four times per year such that all residents had one annual exposure. They consisted of didactics, simulated patient interactions using standardized patients and debriefing with VitalTalk-trained facilitators. A longitudinal clinical scenario was created. The first session included communication to surrogate decision makers about a diagnosis of a degenerative genetic condition. Subsequent sessions focused on determining and delivering goal concordant care as the patient declined over time. This allowed for reflection over the course of a physician-patient relationship. All residents were sent a pre- and post-session survey via REDCap each year they participated to assess comfort level and knowledge. Responses were de-identified, and data analysis is pending. The project received IRB approval.

Between February 2022 and June 2025, 220 residents participated in sessions and completed at least one survey for each session attended. Ninety-nine completed surveys for multiple sessions. We are analyzing data to determine changes in comfort and knowledge based on number of sessions attended.

All pediatricians are required to navigate complex interactions with families. We anticipate that our results will demonstrate the efficacy of serial training and determine the point of knowledge mastery while increasing comfort with communicating serious news.