(325) Evaluation of the GRIEV_ING Educational Intervention on Death Notification in Pediatrics

Introduction: Notifying a parent of their child’s death in a clear and empathetic manner is one of the most difficult tasks for a clinician to perform. The GRIEV_ING educational intervention was designed by Hobgood et al. to teach these communication skills to emergency medicine residents and has since been adapted for anesthesiology and pediatrics. The intervention teaches the GRIEV_ING mnemonic and has been shown to improve confidence and competency based on a pre-post-retention design model.
However, the intervention was designed by clinicians, for clinicians, and was validated by clinician researchers. The perspectives of the surviving family members have not been included. We therefore aimed to implement the GRIEV_ING intervention, with the hypothesis that it will improve provider confidence and competency in utilizing the mnemonic.

Additionally, through thematic analysis of semi-structured interviews with bereaved parent volunteers, we aim to characterize the priorities and values of parents when communicating with clinicians following a child’s death. The themes will then be compared to the components of the GRIEV_ING checklist to assess for points of congruence and divergence. We hypothesize that new themes will emerge from the qualitative data.

Methods: Nine Pediatric Critical Care and Emergency Medicine fellows individually completed a pre-intervention simulation in which they were asked to notify a standardized actor that their child had died. They then received formal training on the GRIEV_ING mnemonic. They repeated the simulation immediately following training and four months later. At each stage, fellows were asked to complete a confidence survey. Their simulations were audio-visually recorded and graded via the GRIEV_ING checklist by two members of the research team.

Bereaved parent volunteers are currently being recruited for evaluation of the audio-visual recordings and semi-structured interviews.

Results: Statistical analysis is ongoing, however preliminary results show:
Average pre/post/retention confidence score = 34.9/44.8/40
Average pre/post/retention competency scores = 19.2/22.1/21.5

Conclusions: Preliminary results reveal that confidence and competency improve with implementation of the GRIEV_ING intervention. Parental feedback is ongoing.