Original Publication
Open Access

Difficult Conversations After Resuscitation in Trauma: Video Education E-Module

Published: May 14, 2015 | 10.15766/mep_2374-8265.10092

Included in this publication:

  • Instructor's Guide.docx
  • Study Guide.docx
  • Video Didactic.mp4
  • ABCDE Pocket Card.docx
  • Comments on Video.pptx
  • Pre-Assessment.docx
  • Post-Assessment.docx

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

Traumatic injury can lead to sudden significant permanent disability or unexpected death for patients. The treating practitioner has no prior relationship with these patients or their families. Informing a family of a bad or uncertain outcome or telling a loved one about a patient’s death after trauma resuscitation is a unique communication skill for surgeons, emergency medicine physicians, and other providers. Moreover, the chaos and demanding nature of the resuscitation and its emotional toll on the team members contribute additional stress to the provider who must deliver the bad news. Traditional methods for breaking bad news such as SPIKES do not directly translate to this unique environment. Curricula to teach these communication skills in a high-stakes trauma setting are needed, but none exist in the literature. This module was created in an attempt to bridge that gap. It offers a study guide for communication following trauma resuscitation, an ABCDE pocket card, a video didactic, and a pre- and postassessment. This electronic-module was designed to be delivered using online educational platforms. However, this module can also be adapted to the classroom setting: completing assessments and watching video in class. In our institution, 34 residents undergoing the educational module completed a presurvey, and 28 residents (82%) completed a postsurvey.  The survey asked about resident perceived knowledge in the skills presented, the value of self-reflection, and the value of the educational experience.  While not statistically significant, there was a trend toward improved resident perception of their knowledge in the domains of breaking bad news and death notification. Eighty-four percent found the module valuable as an educational experience.


Educational Objectives

By the end of this module, learners will be able to:

  1. Outline the steps of the ABCDE algorithm for communicating bad or uncertain prognosis after trauma resuscitation.
  2. Adapt the ABCDE algorithm to delivering news of sudden death after trauma resuscitation.
  3. Identify common emotional responses in family members receiving news of sudden traumatic patient injury.
  4. List strategies to address family emotions after receiving news of sudden traumatic patient injury.
  5. Recognize the challenges of communication after trauma resuscitation.
  6. Describe how to synthesize complicated information for families.
  7. Explain the role of debriefing in communication after trauma resuscitation.
  8. Discuss the value of self-reflection for team health, practice improvement, and personal growth.
  9. Practice written self-reflection.

Author Information

  • Leslie Tyrie, MD: Rutgers New Jersey Medical School
  • Anne Mosenthal, MD: Rutgers New Jersey Medical School
  • Sarah Bryczkowski, MD: Rutgers New Jersey Medical School
  • Chris Laboy: Rutgers New Jersey Medical School
  • Sangeeta Lamba, MD, MBBS: Rutgers New Jersey Medical School

Disclosures
None to report.

Funding/Support
None to report.


References

  1. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES—a six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302-311. http://dx.doi.org/10.1634/theoncologist.5-4-302
  2. Dunn GP, Martensen R, Weissman D, eds. Surgical Palliative Care: A Resident’s Guide. Essex, CT: Cunniff-Dixon Foundation; 2009.
  3. Knops K, Lamba S. Clinical application of ASCEND: a pathway to higher ground for communication. J Palliat Med. 2010;13(7):825-830. http://dx.doi.org/10.1089/jpm.2010.0023



Citation

Tyrie L, Mosenthal A, Bryczkowski S, Laboy C, Lamba S. Difficult conversations after resuscitation in trauma: video education e-module. MedEdPORTAL. 2015;11:10092. https://doi.org/10.15766/mep_2374-8265.10092