Brain Death Determination: An Interprofessional Simulation to Determine Brain Death and Communicate with Families Focused on Neurology Residents

Introduction Significant variation exists in determining brain death despite an expectation of competence for all neurology residents. In addition, family discussions regarding brain death are challenging and may influence organ donation. Methods We developed two simulations of increasing complexity...

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Autores principales:	Nicholas A. Morris, Eli E. Zimmerman, Charles N. Pozner, Galen V. Henderson, Tracey A. Milligan
Formato:	article
Lenguaje:	EN
Publicado:	Association of American Medical Colleges 2020
Materias:	Brain Death Simulation Communication Nurse/Nurse Practitioner Physician Physician Assistant Medicine (General) R5-920 Education L
Acceso en línea:	https://doaj.org/article/49e8eda13e0e45a49e31b675e521d984
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spelling	oai:doaj.org-article:49e8eda13e0e45a49e31b675e521d9842021-11-19T14:47:23ZBrain Death Determination: An Interprofessional Simulation to Determine Brain Death and Communicate with Families Focused on Neurology Residents10.15766/mep_2374-8265.109782374-8265https://doaj.org/article/49e8eda13e0e45a49e31b675e521d9842020-09-01T00:00:00Zhttp://www.mededportal.org/doi/10.15766/mep_2374-8265.10978https://doaj.org/toc/2374-8265Introduction Significant variation exists in determining brain death despite an expectation of competence for all neurology residents. In addition, family discussions regarding brain death are challenging and may influence organ donation. Methods We developed two simulations of increasing complexity for PGY 2 and PGY 3 neurology residents. High-fidelity mannequins were used to simulate patients; standardized actors portrayed family members. In the first simulation, residents determined brain death and shared this information with a grieving family. In the second simulation, residents determined brain death in a more complicated scenario, requiring ancillary testing and accurate result interpretation. Following the determination, residents met with a challenging family. The residents worked with an interdisciplinary team and responded to the family's emotions, used active listening skills, and supported the family through next steps. Results Twelve residents completed the simulations. Prior to the simulation, three (25%) residents felt comfortable discussing a brain death diagnosis; following the simulation, eight (67%) residents felt comfortable/very comfortable discussing brain death. Prior to the simulation, eight (67%) residents stated they knew prerequisites for performing a brain death examination and seven (58%) agreed they knew indications for ancillary testing; these numbers increased to 100% following the simulation. The number of residents who felt comfortable performing the brain death exam increased from five (42%) to 10 (83%). Discussion This simulation of determining brain death and leading difficult family meetings was well-received by neurology residents. Further work should focus on the effects of simulation-based education on practice variation and organ donation consent rates.Nicholas A. MorrisEli E. ZimmermanCharles N. PoznerGalen V. HendersonTracey A. MilliganAssociation of American Medical CollegesarticleBrain DeathSimulationCommunicationNurse/Nurse PractitionerPhysicianPhysician AssistantMedicine (General)R5-920EducationLENMedEdPORTAL, Vol 16 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Brain Death Simulation Communication Nurse/Nurse Practitioner Physician Physician Assistant Medicine (General) R5-920 Education L
spellingShingle	Brain Death Simulation Communication Nurse/Nurse Practitioner Physician Physician Assistant Medicine (General) R5-920 Education L Nicholas A. Morris Eli E. Zimmerman Charles N. Pozner Galen V. Henderson Tracey A. Milligan Brain Death Determination: An Interprofessional Simulation to Determine Brain Death and Communicate with Families Focused on Neurology Residents
description	Introduction Significant variation exists in determining brain death despite an expectation of competence for all neurology residents. In addition, family discussions regarding brain death are challenging and may influence organ donation. Methods We developed two simulations of increasing complexity for PGY 2 and PGY 3 neurology residents. High-fidelity mannequins were used to simulate patients; standardized actors portrayed family members. In the first simulation, residents determined brain death and shared this information with a grieving family. In the second simulation, residents determined brain death in a more complicated scenario, requiring ancillary testing and accurate result interpretation. Following the determination, residents met with a challenging family. The residents worked with an interdisciplinary team and responded to the family's emotions, used active listening skills, and supported the family through next steps. Results Twelve residents completed the simulations. Prior to the simulation, three (25%) residents felt comfortable discussing a brain death diagnosis; following the simulation, eight (67%) residents felt comfortable/very comfortable discussing brain death. Prior to the simulation, eight (67%) residents stated they knew prerequisites for performing a brain death examination and seven (58%) agreed they knew indications for ancillary testing; these numbers increased to 100% following the simulation. The number of residents who felt comfortable performing the brain death exam increased from five (42%) to 10 (83%). Discussion This simulation of determining brain death and leading difficult family meetings was well-received by neurology residents. Further work should focus on the effects of simulation-based education on practice variation and organ donation consent rates.
format	article
author	Nicholas A. Morris Eli E. Zimmerman Charles N. Pozner Galen V. Henderson Tracey A. Milligan
author_facet	Nicholas A. Morris Eli E. Zimmerman Charles N. Pozner Galen V. Henderson Tracey A. Milligan
author_sort	Nicholas A. Morris
title	Brain Death Determination: An Interprofessional Simulation to Determine Brain Death and Communicate with Families Focused on Neurology Residents
title_short	Brain Death Determination: An Interprofessional Simulation to Determine Brain Death and Communicate with Families Focused on Neurology Residents
title_full	Brain Death Determination: An Interprofessional Simulation to Determine Brain Death and Communicate with Families Focused on Neurology Residents
title_fullStr	Brain Death Determination: An Interprofessional Simulation to Determine Brain Death and Communicate with Families Focused on Neurology Residents
title_full_unstemmed	Brain Death Determination: An Interprofessional Simulation to Determine Brain Death and Communicate with Families Focused on Neurology Residents
title_sort	brain death determination: an interprofessional simulation to determine brain death and communicate with families focused on neurology residents
publisher	Association of American Medical Colleges
publishDate	2020
url	https://doaj.org/article/49e8eda13e0e45a49e31b675e521d984
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Brain Death Determination: An Interprofessional Simulation to Determine Brain Death and Communicate with Families Focused on Neurology Residents

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