P2.177: PEMTalk: Improving Delivery of Serious News in Pediatric Emergency Medicine

Background: Pediatric emergency medicine (PEM) physicians encounter patients and their families for the first time during stressful and challenging situations and are often tasked with delivering serious news (DSN), impacting both families and physicians. Barriers to effective communication include limited time, lack of established relationship, and inadequate training. Our objective was to assess the impact of a specialized communication course on DSN in improving PEM physicians’ self-perceived preparedness, skill level, and stress management.

Methods: We designed a simulation-based communication workshop “PEMTalk,” utilizing trained standardized patients to teach PEM attendings and fellows to effectively deliver serious news at two children’s hospitals from 2018 – 2023. Adapted from the VitalTalk framework, three cases specific to PEM were developed for participants to DSN. The workshop was conducted both in the virtual and in-person format. Pre- and post-intervention surveys utilizing Likert scales assessed participants' comfort with DSN, respond to emotions, express empathy, and workshop’s overall impact.

Results: 74 participants completed the surveys, among which 53% were fellows. 31% attended the workshop more than once. Among the 34 first-time participants, there was an improvement in how providers felt about their ability to DSN (41% vs 97%, p < 0.001), respond to emotions (50% vs 97%, p < 0.001), and decrease in significant stress (47% vs 21%, p = 0.003). Among the 23 participants who participated in the study more than once, there was sustained improvement in their self-perceived ability to DSN (39% vs. 69%, p = 0.02). Fellows were more likely to report improvement compared to attendings. There was no difference in impact between the in-person or virtual formats.

Conclusion: PEMTalk effectively enhanced participants’ perceived abilities to DSN in a simulated setting, express empathy, and respond to emotion, while reducing stress due to DSN. Next steps include using an objective assessment tool, including impact on patient care and patient experiences, as well as dissemination of PEMTalk to provide ongoing support and training for a broader PEM community.