• Erin M Johnson, Melinda F Hamilton, R Scott Watson, Rene Claxton, Michael Barnett, Ann E Thompson, and Robert Arnold.
• 1Department of Critical Care Medicine, The Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA. 2Peter M. Winter Institute for Simulation, Education, and Research (WISER), Pittsburgh, PA. 3Department of Pediatrics, University of Washington, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, WA. 4Division of General Internal Medicine, The University of Pittsburgh Medical Center, Pittsburgh, PA. 5University of Alabama at Birmingham, Birmingham, AL.
• Pediatr Crit Care Me. 2017 Aug 1; 18 (8): e348-e355.

ObjectiveEffective communication among providers, families, and patients is essential in critical care but is often inadequate in the PICU. To address the lack of communication education pediatric critical care medicine fellows receive, the Children's Hospital of Pittsburgh PICU developed a simulation-based communication course, Pediatric Critical Care Communication course. Pediatric critical care medicine trainees have limited prior training in communication and will have increased confidence in their communication skills after participating in the Pediatric Critical Care Communication course.DesignPediatric Critical Care Communication is a 3-day course taken once during fellowship featuring simulation with actors portraying family members.SettingOff-site conference space as part of a pediatric critical care medicine educational curriculum.SubjectsPediatric Critical Care Medicine Fellows.InterventionsDidactic sessions and interactive simulation scenarios.Measurements And Main ResultsPrior to and after the course, fellows complete an anonymous survey asking about 1) prior instruction in communication, 2) preparedness for difficult conversations, 3) attitudes about end-of-life care, and 4) course satisfaction. We compared pre- and postcourse surveys using paired Student t test. Most of the 38 fellows who participated over 4 years had no prior communication training in conducting a care conference (70%), providing bad news (57%), or discussing end-of-life options (75%). Across all four iterations of the course, fellows after the course reported increased confidence across many topics of communication, including giving bad news, conducting a family conference, eliciting both a family's emotional reaction to their child's illness and their concerns at the end of a child's life, discussing a child's code status, and discussing religious issues. Specifically, fellows in 2014 reported significant increases in self-perceived preparedness to provide empathic communication to families regarding many aspects of discussing critical care, end-of-life care, and religious issues with patients' families (p < 0.05). The majority of fellows (90%) recommended that the course be required in pediatric critical care medicine fellowship.ConclusionsThe Pediatric Critical Care Communication course increased fellow confidence in having difficult discussions common in the PICU. Fellows highly recommend it as part of PICU education. Further work should focus on the course's impact on family satisfaction with fellow communication.

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