Objective:

To study the impact of a standardized brain death curriculum on physician and nurse competence, confidence, and comfort.

Background:

There is decreased familiarity with and exposure to brain death amongst medical professionals when compared with cardiac death. Therefore, targeted education should be offered to multidisciplinary healthcare providers to impact competence and familiarity with this entity.

Design/Methods:

Brain death educational curricula were developed for and offered to (A) neurosciences and critical care physicians to effect accurate declaration and discussion of brain death, and (B) critical care nursing to improve confidence and competence in answering family questions about brain death at the bedside. Trainees and attending physicians underwent a formal didactic followed by simulation-based training incorporating examination and communication skills. Critical care nurses underwent formalized didactic followed by peer-based simulated conversations of frequently asked questions. All participants submitted pre-curriculum and post-curriculum surveys that included a combination of Likert, fill-in, and multiple-choice questions as well as a knowledge test. Wilcoxon signed-rank test and Kruskal-Wallis test were used for statistical analysis (P<0.05).

Results:

46 neurosciences and critical care physicians and 21 critical care nurses participated in their respective brain death curriculum. Mean scores on knowledge test improved from 5.3 to 6.9 out of 10 for physicians (p<0.001) and from 4.2 to 6.2 out of 8 for nurses (p<0.001). Mean physician confidence in performing independent brain death declaration increased from 3.6 to 7.7, out of 10 (p<0.001). Mean physician comfort documenting a brain death assessment increased from 3.7 to 7.9, out of 10 (p<0.001). Mean comfort in discussing brain death with patients’ family increased from 5.0 to 8.1 for physicians and from 5.3 to 7.8 for nurses (both out of 10, both p<0.001). 

Conclusions:

Formalized education on brain death improves confidence, comfort, and competence in brain death among physicians and nurses.