Introduction: Pediatric critical care medicine (PCCM) fellows must learn to conduct serious illness conversations with patients and families prior to graduation. Communication training is not standardized, with some programs offering dedicated communication training sessions while others utilize ad hoc, on the job training only. We developed a four-day, simulation-based communication curriculum for PCCM fellows focused on responding to emotion, delivering serious news, and discussing goals of care. Methods: PCCM fellows participated in 2-day workshops in the spring of their first year and again in the winter of their third year. Workshops utilized VitalTalk methodology including didactics and simulation. Fellows completed anonymous surveys before and after each workshop assessing their confidence in 15 communication skills at four timepoints (before and after the first-year workshop, and before and after the third-year workshop). Skills assessed included complex communication tasks like delivering serious news, leading a care conference, and discussing code status, and more specific skills like allowing for silence and discussing spiritual issues. Surveys used a 5-point Likert scale to assess confidence and responses were compared using unpaired t-tests. Results: From 2019 through 2025, 27 first years and 29 third years participated in the training, with 82% finishing their surveys. Between the first year pre and post surveys, fellows’ confidence increased in all 15 skills assessed by an average of +1.1 points (95% CI +.9 to +1.3). Confidence on average decreased by 0.7 between the first- and third-year course (95% CI -.4 to -.9). The third-year workshop further increased fellows’ confidence by an average of +.8 (95% CI +.6 to +1). Between the first-year pre surveys and the third-year post surveys there was an average +1.3 increase across all categories (95% CI +1.1 to +1.4). Conclusions: A comprehensive curriculum to teach serious illness communication skills improves graduating fellows’ confidence in this complex and important task. Confidence falls between first and third year of fellowship, highlighting the necessity of ongoing training. Additional research is needed to evaluate how individuals utilize this training in their clinical practice after fellowship.
Bagg et al. (Sun,) studied this question.