Simulation-Based Communication Skills Training for Experienced Clinicians to Improve Family Conversations About Organ and Tissue Donation.

INTRODUCTION: The approach, communication skills, and confidence of clinicians responsible for raising deceased organ donation may influence families' donation decisions. The aim of this study was to increase the preparedness and confidence of intensive care clinicians allocated to work in a "designated requester" role. DESIGN: We conducted a posttest evaluation of an innovative simulation-based training program. Simulation-based training enabled clinicians to rehearse the "balanced approach" to family donation conversations (FDCs) in the designated requester role. Professional actors played family members in simulated clinical settings using authentic scenarios, with video-assisted reflective debriefing. Participants completed an evaluation after the workshop. Simple descriptive statistical analysis and content analysis were performed. RESULTS: Between January 2013 and July 2015, 25 workshops were undertaken with 86 participants; 82 (95.3%) returned evaluations. Respondents were registered practicing clinicians; over half (44/82; 53.7%) were intensivists. Most attended a single workshop. Evaluations were overwhelmingly positive with the majority rating workshops as outstanding (64/80; 80%). Scenario fidelity, competence of the actors, opportunity to practice and receive feedback on performance, and feedback from actors, both in and out of character, were particularly valued. Most (76/78; 97.4%) reported feeling more confident about their designated requester role. DISCUSSION: Simulation-based communication training for the designated requester role in FDCs increased the knowledge and confidence of clinicians to raise the topic of donation.

Relational conflict and outcomes from an online divorce education program.

The impact of conflict on co-parenting outcomes of divorce education programs is not widely explored in the literature despite the prevalence of conflict in divorce. This study used outcome data from a sample of participants (N=272) who took the online Parents Forever™ course between 2012 and 2014. Participants were asked questions about positive and negative co-parenting behaviors as well their levels of conflict before and after the divorce or separation. There was on average a slight increase in conflict from post to follow-up (M=-0.397, SD=1.54). Simple linear regression analyses indicated that change in conflict explained a significant proportion of the variance in positive co-parenting scores, R2=0.07, F(1, 270)=19.98, p<0.001 and negative co-parenting scores, R2=0.08, F(1, 270)=23.78, p<0.001. Results suggest that conflict significantly impacts co-parenting behaviors targeted in the Parents Forever ™ course.