Adult Death Disclosure to a Surviving Spouse

MedEdPORTAL

卷:11

Paul DeSandre¹  Jeffrey Siegelman²  Pearl Arnovitz³  Tammie Quest⁴ 

[1] 1 Emory University School of Medicine;

[2] 2 Emory University School of Medicine;

[3] 3 Emory University School of Medicine;

[4] 4 Emory University School of Medicine;

关键词: Standardized Patient;    Palliative Medicine;    Death Disclosure;   

DOI  :  10.15766/mep_2374-8265.10207

来源: DOAJ

【 摘 要 】

Abstract Introduction Delivering a death disclosure is a routine but high-stakes part of the practice of an emergency physician. However, this is a skill that is conducted with a wide range of competence by both residents and faculty and one that can be improved through practice. This is a standardized patient (SP) scenario created to teach emergency medicine interns how to deliver a death disclosure in the case of an adult. This case was created as part of a hands-on session for emergency medicine interns to increase their comfort and competence with death disclosures. Methods A 1-hour didactic session on death disclosure for the interns precedes the SP encounter. The learners then participate in the SP scenario regarding the delivery of a death disclosure to the spouse of a patient. During the scenario, the learners were observed by the SP, the faculty rater, and a peer, all of whom delivered feedback. The faculty rater completes the direct observation tool which was created using language which maps to the emergency medicine milestones. Debriefing following the session takes place with the faculty, the resident, a peer, and the SP all present. The discussion focuses on the emotional toll of this conversation on both the learner and the SP, as well as the intern's ability to utilize the format presented in the didactic session. Results Following implementation, feedback from interns was positive in that most enjoyed the experience and found it to be a valuable use of resources. In addition, most were able to utilize the death disclosure construct that was taught in the morning didactic session. The session length was appropriate for the case and debriefing. Early experience and outcomes with the curriculum have been previously published and demonstrated a perceived increase in the number of interns confident they could perform death disclosure from 29% (prescenario) to 67% (postscenario). Discussion This SP scenario was created to teach emergency medicine interns how to deliver a death disclosure in the case of an adult. Communication skills necessary for such a conversation are a focus of the ACGME milestones in emergency medicine. Over time, we have modified the assessment tool to reflect the use of these milestones in resident assessment. We also had to expand the resources expended on this curriculum to accommodate growing class sizes. Finally, we have eliminated discussion of bad news delivery, focusing instead on death disclosure exclusively due to time constraints.

【 授权许可】

Unknown