Objective. To determine if pediatric residents and emergency department (ED
) fellows could improve their ability to counsel and inform standardized pa
tients (SPs) about bad news.
Methodology. A crossover, self-controlled design in which trainees were the
ir own control individuals, and SPs provided feedback after the first inter
view. The setting was the consultation room in the ED of a large children's
hospital. The outcome measures included examining the counseling and infor
ming skills of study participants.
Results. Trainees improved their informing skills after being provided feed
back in the broad areas of communication and follow-up and in the total num
ber of content areas asked. Their counseling skills improved in two areas:
1) promoting more trust and 2) making parents feel less dependent. Those tr
ainees who scored higher on counseling skills discussed more total and crit
ical content issues with SPs in the study. Trainee feedback revealed a very
high rating of the educational process, and the trainees also felt much mo
re confident about their skills after the first and second sessions.
Conclusions. Using SPs to teach residents and ED fellows to give bad news i
s an effective educational process that provides trainees with interactions
that simulate real-life experience.