Among the most frequent and challenging scenarios encountered in neonatal-perinatal medicine (NPM) is the decision-making discussion about the severely ill infant in the neonatal intensive care unit (NICU). Many of these infants are at significant risk of early death, suffering, or long term disabilities. Trainees must be able to negotiate these complex scenarios by utilizing professionalism, communication, and ethical knowledge. To integrate this technique and facilitate these communication competencies at the University of Ottawa, we developed a small-group workshop with standardized patients (SPs) called Scenario-Oriented Learning in Ethics (SOLE): Critically Ill Newborn in the NICU. SOLE uses SPs as a teaching tool to impart knowledge on the principal and the three key competencies of the Neonatal Ethics Teaching Program that trainees are expected to acquire before completing their NPM training at the university. The goal of this workshop is to help trainees show improvement in their communication skills and demonstrate appropriate application of ethical principles when they have to interact with parents in delicate, difficult, and ethically charged situations regarding their child. The workshop’s format integrates debriefing which is known to be associated with critical thinking/reflection as it allows the trainee to reflect during the action, analyze the situation, and make adjustments drawing on their previous knowledge and experience to the ongoing conversation with the parent. At the end of one rotation between the SP and a trainee the supervisor guides debriefing, concentrating on learning outcomes. Enough time is provided for participants to verbalize their feelings and completely debrief. At the conclusion of the scenario, the SPs share their feedback by summarizing two or three points that are valuable to the trainees. This time is also used for the participant to summarize and identify their strengths and areas needing improvement in order to be able to become a better communicator and professional.
- Distinguish the three parent rationales behind the question: “If my baby was yours, what would you do?”
- Explain the appropriate response to the parent questions: “Have you done everything you can for my baby?”
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