North Texas Research Forum 2025

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Division

North Texas

Hospital

Medical City Arlington

Specialty

Internal Medicine

Document Type

Presentation

Publication Date

2025

Keywords

brain death, death by neurological criteria, DNC, quality improvement

Disciplines

Internal Medicine | Medicine and Health Sciences | Nervous System Diseases | Quality Improvement

Abstract

Background: Clinical brain death determination requires both technical proficiency and sensitive communication with families. However, residents often report inadequate training and confidence in performing and discussing these examinations. This study evaluated an educational intervention combining didactic training and simulation to improve residents’ competence in brain death protocols and family communication. Methods: A mixed-methods cohort study was conducted with resident physicians. Participants completed a pre-intervention questionnaire assessing baseline knowledge, experience, and confidence in brain death determination and communication. An educational session reviewed clinical criteria, examination protocols, and communication strategies. Residents then engaged in an in-person simulation with standardized actors portraying grieving family members, while others observed live video recordings of these interactions. Post-simulation debriefs and a repeat questionnaire evaluated changes in confidence and preparedness. Results: Of 15 initial participants (8 PGY-1, 5 PGY-2, 2 PGY-3), 67% reported prior didactic training, yet 67% (n=10) had never performed a brain death examination, and 47% (n=7) lacked confidence in doing so. All participants agreed that increased exposure to brain death protocols would improve their preparedness. Post-intervention, 5 residents (4 PGY-1, 1 PGY-2) completed follow-up assessments, with 100% strongly agreeing they felt confident communicating brain death to families. Conclusion: Simulation-based training demonstrated preliminary potential to enhance resident confidence in discussing and performing brain death examinations, particularly among junior trainees. However, low post-intervention response rates (33% of initial cohort) limited statistical significance. These findings underscore the need for structured training in this high-stakes clinical task

Original Publisher

HCA Healthcare Graduate Medical Education

Effective Communication in the Pronunciation of Brain Death

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