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. 2022 Apr;46(3):151529.
doi: 10.1016/j.semperi.2021.151529. Epub 2021 Nov 9.

Decision making at extreme prematurity: Innovation in clinician education

Anne Sullivan  1 , Christy L Cummings  2
Affiliations

Decision making at extreme prematurity: Innovation in clinician education

Anne Sullivan et al. Semin Perinatol. 2022 Apr.

Abstract

Decision-making at extreme prematurity remains ethically and practically challenging and can result in parental and clinician distress. It is vital that clinicians learn the necessary skills integral to counseling and decision-making with families in these situations. A pedagogical approach to teaching counseling should incorporate adult learning theory, emphasize multidisciplinary team in-situ simulation that links to counseling clinicians' daily practice, and includes critical reflection, debriefing, and program assessment. Multiple educational strategies that train clinicians in advanced communication and decision-making offer promising results to optimize antenatal counseling and shared decision-making for families facing possible delivery at extreme prematurity. Continued process evaluation and innovation in these educational domains are needed while also assessing the effect on patient-centered outcomes.

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Conflict of interest statement

Declaration of Competing Interest C. Cummings is grateful for support by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health under award number R01HD094794 (CC PI). A. Sullivan is grateful for support from the NICHD of the National Institutes of Health under award number T32HD098061. The authors report no other proprietary or commercial interest in any product mentioned or concept discussed in this article.

References

    1. Raju TNK, Mercer BM, Burchfield DJ, Joseph GF. Periviable birth: Executive summary of a Joint Workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Academy of Pediatrics, and American College of Obstetricians and. J Perinatol. 2014;34(5):333–342. doi:10.1038/jp.2014.70 - DOI - PubMed
    1. Arzuaga BH, Cummings CL. Practices and education surrounding anticipated periviable deliveries among neonatal-perinatal medicine and maternal-fetal medicine fellowship programs. J Perinatol. 2016;36(9):699–703. doi:10.1038/jp.2016.68 - DOI - PubMed
    1. Stokes TA, Watson KL, Boss RD. Teaching antenatal counseling skills to neonatal providers. Semin Perinatol. 2014;38(1):47–51. doi:10.1053/j.semperi.2013.07.008 - DOI - PubMed
    1. Boss RD, Hutton N, Sulpar LJ, West AM, Donohue PK. Values Parents Apply to Decision-Making Regarding Delivery Room Resuscitation for High-Risk Newborns. Pediatrics. 2008;122(3):583–589. doi:10.1542/peds.2007-1972 - DOI - PubMed
    1. Kukora SK, Boss RD. Values-based shared decision-making in the antenatal period. Semin Fetal Neonatal Med. 2018;23(1):17–24. doi:10.1016/j.siny.2017.09.003 - DOI - PubMed

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