Purpose: To evaluate the effectiveness of a one-day training program using Standardized Parents (SPs) to improve the performance of Pediatric ICU fellows in delivering bad news.

Methods: All Pediatric ICU fellows in our program were given two case scenarios of patients admitted to the ICU with a near fatal diagnosis. They were instructed to interview one set of SPs in the morning and the second set of SPs in the afternoon. The SPs had received 15 hours of training in role playing, performance evaluation, and giving feedback to the physicians. At the end of the first interview, SPs provided feedback to the fellows on their performance and counseling skills using standardized checklists. During the second session, fellows had an opportunity to interview another set of SPs with a similar case scenario. The research methodology used was a self-control, cross over design. Both the sessions were videotaped and physician performance was evaluated by a rater blinded to the order of the sessions, using a weighted scale based on the performance checklist.

Results: The overall performance by the ICU fellows showed a statistically significant improvement of 18% ± 5% (Standard Error of Mean) between the first and the second interviews. Ranking of session scores revealed that the physician performance improved significantly during the second session (Wilcoxon's signed rank test, p = 0.0002). A significant improvement in physician performance was seen in interpersonal skills of 35%± 38% (Standard Error of Mean), (p value = 0.0015)

Conclusions: Short term improvement in physician performance in parent meetings can be achieved with an educational feedback program using SPs.