Dr. Bradley Harrold remembers the first time he had to deliver bad news to a family. “It was traumatic for everyone involved and it never gets easier - ever,” said Harrold, a fellow in pulmonary and critical care medicine. A training program has been developed at Ohio State University to improve how physicians address this topic with families. With more than 90,000 patients waiting for a solid organ transplant, a clear explanation about brain death is an important first step before families can begin considering the option of organ donation.
“If interactions between doctors and families about brain death are uncomfortable or incomplete, any future discussions about organ donation can be impeded,” says June Hinkle, who works with the families of critically ill or injured patients at The Ohio State University Medical Center.
The training at Ohio State takes place in an educational laboratory with dozens of mock exam rooms equipped with cameras and panes of one-way viewing glass. Paid actors play the roles of family members who are about to learn for the first time that a loved one has suffered brain death.
Hinkle said the interactions are very realistic, right down to the tears and the emotions that one would expect to encounter when bad news is delivered. At the end of each ten to 15 minute scenario - after the doctor has left the room - the “family” completes an evaluation form. Everything from the doctor’s composure and knowledge about brain death to any distracting mannerisms are noted. The data also is used by preceptors to coach the physicians.
“We teach doctors to look for certain behavioral cues that may signal a person’s lack of understanding about brain death and to use words that are clear and concise,” said Hinkle. “Only after the family hears the prognosis in a clear and meaningful way can they begin making important end of life decisions, which could include organ donation.”
MEDICA.de; Source: Ohio State University Medical Center