Introduction Variability in determination of brain death (BD) is well documented. Reducing this variation is key to maintaining public trust in this diagnosis, and to saving lives through organ donation. The skill to accurately perform a BD examination, and assure families understand that their loved one has died, is critical in preparing families for an effective organ donation conversation. Training on determination of BD and skills requisite to communicate with families are not incorporated into most medical school education. A survey of 3 academic medical centers identified lack of BD training in nearly 1 in 4 academic physicians. (Braksick SA, 2019). Another study identified 41% of residents reported never being taught how to explain BD to families. (Iman N. Afif, 2021)

Methods A U.S. OPO and its affiliated international training center (ITC) partnered with a virtual solutions company to create “Determination of Brain Death and Family Communication Physician Training Program” using a scenario-based eLearning/simulation module. The eLearning focuses on strengthening physician communication skills to help families comprehend the BD determination process including grasping final news of death. Learners are directed to the companion application (VR) where they learn to perform a bedside neurological exam and apnea test in a virtual setting. Training is accessible by mobile phone, tablet, or computer.

The development team (OPO/ITC) worked with five senior neurocritical care physicians. An additional 12 physicians with neurology, trauma and critical care expertise participated in the testing phases. Their feedback enhanced the medically accurate VR simulation that recreates patient responses and demonstrates use of associated medical instruments/monitoring devices. The ITC/OPO partnered with an academic medical center to assess impact/perceived efficacy of VR simulation-based training through pre/post training tests.

Results Launched in January 2023, the program was introduced in OPO’s Donor Service Area (DSA) via online seminar by ITC and a Chief Neurocritical Care/SME to 140 physicians from 45 hospitals. Training is currently being disseminated in the OPO’s DSA. To date, 200 physicians have enrolled with 47 completing the training. Preliminary data indicates more than 95% of learners report increased confidence in preparing families and communicating determination of BD. In addition, 100% stated this training improved overall confidence and knowledge in performing all aspects of BD determination.

Conclusion By OPOs offering this training nationwide via ITC to physicians, medical schools, and residency programs, physicians will gain knowledge/skills to perform BD testing and effectively communicate results with families.