Remote behavioral skills training for physicians on COVID-19 death notification

Abstract

Death notification is a frequent and stressful task in critical care. During COVID-19, the number of deaths increased significantly, and health personnel had to deliver this news remotely without preparation. In international research, training protocols have been described that improve physician’s communication skills and self-confidence, as well as remote communication suggestions to COVID-19. However, these recommendations are subjective and ambiguous, which can hinder their replicability. This research adopts the principles of Applied Behavioral Analysis to implement a Behavioral Skills Training to identify, validate, and train the behaviors required to properly communicate a remote death notification for COVID-19 in three pilot participants. Nineteen operational definitions of the behaviors were generated and trained on three intensive care residents. Two participants demonstrated strong effect sizes following training, while the third participant did not complete the training. These preliminary results suggest that implementing a remote death notification behavioral skills training program might be feasible and effective, and could also be useful in face-to-face settings.