Since its inception, Sala Institute for Child and Family Centered Care has collaborated with the Pediatric Residency Program at NYU Grossman School of Medicine to teach trainees best practices in family-centered care and communication. The cornerstone of this partnership is the Pediatric Residency Communication Curriculum, in which residents benefit from the expertise of both experienced clinicians and Sala’s Patient and Family Faculty members. Patient and Family Faculty are teens or parents of children who are receiving or recently received care at Hassenfeld Children’s Hospital at NYU Langone.
“Effective physician-parent communication skills are foundational in Pediatrics,” says Heather B. Howell, MD, director of the Pediatric Residency Program. “The objective of the communications curriculum program is to provide the residents with tools to optimize their communication skills.”
Building skills over three years
The curriculum’s challenging, real-life scenarios take place over the course of the trainee’s three-year residency. Each scenario involves role-plays with an actor and are observed by an experienced clinician and a family faculty member.
“The simulations we provide to residents allows them to learn about and practice family communication in a very hands-on way,” says Rachel Ramsey, MHA, administrative director at Sala Institute. “They receive direct, actionable feedback from Sala Family Faculty members and experienced physicians that they can apply in their everyday interactions with patients and families.”
Practicing increasingly difficult conversations
In year one, the focus is on learning to deliver relationship-centered care. An actor plays the family member while the resident goes through a simulation disclosing a minor medical error to the family. After the simulation, the resident, actor, family faculty, and physician debrief using Sala’s patient and family-centered core competencies as their guide.
In year two, residents learn skills to handle challenging conversations with patients or parents. This time, the simulation involves a baby who is unintentionally not receiving enough food at home. The resident must make the actor parent aware of the child’s failure to thrive while maintaining rapport. Debriefs review how to have conversations with families in challenging circumstances that impact their child’s health and wellbeing.
“Recently, I had to tell a mother that her premature infant was not responding to the therapies used to treat his illness. The mother had been suffering and experiencing significant distress,” says Dr. Dr. Jenna Berson, a recent graduate of the Pediatric Residency Program. “I could feel myself wanting to jump in and reassure her, but I was guided by the discussion with the Sala family advisor and spent more time quietly listening to this mother share what she was feeling without offering her blanket statements of reassurance.”
In their final year, residents learn to manage difficult conversations in three simulated discussions:
- expressing concern for the family’s intentional physical harm to a child,
- a conversation in the emergency room about a possible new cancer diagnosis after what was supposed to be a routine well baby visit, and
- disclosing a serious medical error.
The third year closes with an interactive session co-led by Family Faculty members and the residency program director. Family faculty offer their personal perspectives on doctor-family communication during some of the most pivotal moments in their children’s lives.
Lasting impact on graduates
“What families shared was often directly applicable to the next conversation I was having with a parent and the feedback has stayed with me during my residency and now into my fellowship,” says Dr. Berson.
To date, more than 100 pediatric residents have participated in at least one year of the program, which began in 2019. In June 2022, all 20 graduating residents were the first cohort to experience all three years of the curriculum.
Sala Institute provides vital supportive services and resilience programs to children and families and partners with healthcare providers to deliver the safest, highest quality care possible at Hassenfeld Children’s Hospital at NYU Langone. This powerful combination of services helps children heal and families feel supported. This type of care is absolutely essential, and it is made possible with generous philanthropic support.