Talkvermont Pediatrics: Learning to Discuss What Matters Most to Patients and Their Families. Development and Implementation of an Interprofessional Communication Course Curriculum

Background: Goals of care (GOC) conversations in pediatrics have nuanced complexities. A health care team proficient in such communication is essential. Yet, providers across studies report lack of training and comfort with these discussions, which negatively impacts quality of care and may contribute to provider burnout. TalkVermontPediatrics aimed to create an interprofessional communication course curriculum to meet the unique needs of pediatric patients and families.

Methods: TalkVermontPediatrics is adapted from evidence-based teaching methods that include patient simulation, deliberate practice and cognitive mapping. The 2-year pilot included a total of 5 sessions. We conducted 2 in-person courses that consisted of 8 hours of didactics and interprofessional small group interactions that included case-based simulation and reflection. Due to the pandemic we transitioned to virtual courses for the remaining 3 sessions that consisted of same material but was divided over two half days. Initial and 3 month follow-up participant surveys assessed experience with serious illness communication, course skills utilized in practice, and change in confidence for skills taught. Surveys also investigated course satisfaction, inter-professional interactions, and job satisfaction.

Results: A total of 55 participants completed the initial questionnaire (virtual courses= 35 (63.6%), in-person courses= 20 (36.4%)). 26 physicians (47.3%), 1 advanced practice provider (1.8%), 19 nurses (34.5%), 5 social workers (9.1%) and 4 child life specialists (7.3%) participated in the course. Nearly 55% had received prior communication skills training that were mostly taught through didactics. Immediately after the course 98.2% of participants felt that they could apply what they learned in the course and 100% agreed that they plan to make changes to their clinical practice. All participants rated increased confidence in responding to emotion, sharing serious news, asking about a patient’s values, and making a recommendation to a patient/family member. There was no statistical difference between the in-person or virtual courses in course satisfaction or increase in skill confidence.

35 participants (63.6% completed the follow up survey). In the 3-month follow up, participants self-reported a significant increase in skill use for permission statements and using headlines to share news. More than a majority of participants self-reported that serious illness conversations have changed as a result of the course and 95% agreed that communication skills should be learned with other professions.

Conclusion: We created a GOC communication course curriculum specific to the pediatric population. We successfully conducted in-person as well as virtual courses for interprofessional learners. We integrated innovative learning techniques with asynchronous and synchronous elements. Learner feedback showed that course material and teaching methods advanced learners skills and confidence around GOC discussions with their patients and families. Learners valued the interprofessional element of this course as essential for successful GOC communication. We demonstrated that these courses can be taught virtually with the same impact on learning.