Development of an Effective Comprehensive Curriculum Regarding the Patient and Provider Experience of Stillbirth

Abstract

PURPOSE: To develop and evaluate a comprehensive curriculum about stillbirth focused on both the patient and the provider experience with this difficult topic. BACKGROUND: Pilot data from our institution showed that OB/GYN residents felt ill prepared to care for patients with stillbirth, and that training about the patient experience of stillbirth was impactful but emotionally distressing. We sought to develop a comprehensive stillbirth curriculum that included knowledge, communication skills, and emotional domains. METHODS: A four-part curriculum was created including: 1. Medical management, 2. A stillbirth panel discussion with patients/families, 3. Simulation training in delivering serious news, and 4. Workshop on resiliency. OB/GYN residents completed pre- and post-testing for each session. Five-point Likert scales were compared using the Wilcoxon signed rank test (alpha = 0.05). RESULTS: All 28 residents participated in parts of the curriculum, with 85% attending two or more sessions. Following the curriculum, we found statistically significant self-reported improvements in multiple aspects of the stillbirth training: general knowledge (P<.01), appropriate tests to order (P<.05), interpretation of placental pathology (P<.01), genetic evaluation (P<.01), comfort conveying sympathy (P<.05), expressing emotion (P<.01), and confidence in delivering serious news (P<.001). In the resiliency workshop, residents shared ideas about how faculty can support them during difficult clinical situations. DISCUSSION: A comprehensive stillbirth curriculum which addressed the cognitive, emotional, and skills aspects of this topic was well received and effective. Long-term data is needed to evaluate whether these improvements persist and can enhance resident satisfaction with other challenging topics within OB/GYN.