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The announcement of a cancer diagnosis is a crucial moment in the management of the disease, as it is the starting point for a relationship of trust between patient and caregiver. In 2005, this issue led to the creation of an announcement system as part of the 2003-2007 cancer plan, but its implementation in practice remains uncertain. Pediatric oncology has its own specificities, with a triangular relationship and the need for doctors to adapt to the child's age. These skills require special training, and training opportunities vary from one area to another. To this end, the Angers and Caen centers have developed simulation exercises for training in pediatric oncology announcement. These consist of a theoretical part, followed by an announcement interview with actors, then a debriefing. Evaluation questionnaires are completed by learners before and after the session, and have highlighted the usefulness of this training, particularly in helping them to feel better prepared to face this stressful moment. As simulation has proved its educational value in the healthcare field, GOCE has developed simulation-based training courses for interns/CCAs/assistants in the territory. These courses are much appreciated and are proving extremely useful in clinical practice. This has led the SFCE to extend these courses to all CCAs and young PHs in pediatric oncology in France., (Copyright © 2024. Published by Elsevier Masson SAS.)

Background: Effective physician-patient communication is crucial to compassionate healthcare, particularly when conveying life-altering diagnoses such as those associated with congenital heart diseases. Despite its importance, medical practitioners often face challenges in communicating effectively. Because of these gaps, we aim to introduce a simulation-based training protocol to improve pediatric cardiology trainee's communication skills. This study will be conducted in collaboration with associations supporting caregivers of children with congenital heart disease. It strives to demonstrate how specific training programs can efficiently foster humanistic, patient-centered care in standard medical practice., Methods: This multicenter, open-label randomized controlled trial will be conducted in pediatric cardiac units and simulation centers of across 10 universities in France. The study population comprises pediatric cardiologists in training (including pediatric cardiac fellows or specialist assistants). The SIMUL-CHD intervention will consist of simulation-based training with standardized patients, focusing on improving communication skills for pediatric cardiology trainees during diagnostic counselling. Patients and caregivers have been recruited from a National Patient Association named "Petit Cœur de Beurre". The primary outcome is the quality of physicians' communication skills. The evaluation committee, which will review video recordings of the sessions, will be blinded to which participants received simulation-based training (group of interest) and which received theory-based training (control group). Secondary outcomes are the effect of SIMUL-CHD on empathy and anxiety levels in young pediatric cardiologists. Baseline scores pre and post-intervention will be compared, and skill improvement resulting from the intervention measured., Discussion: Simulation-based training has proven efficacy in teaching technical skills in various scenarios however its application to communication skills in pediatric cardiology remains unexplored. The involvement of experienced parents provides a unique perspective, incorporating their profound understanding of the emotional challenges and specific hurdles faced by families dealing with congenital heart disease., Trial Registration: This trial is registered with the OSF registry (registered https://osf.io/ed78q )., (© 2024. The Author(s).)

Stroke, a major burden to society, can now be treated in increasingly larger numbers of patients. Intravenous thrombolysis and mechanical thrombectomy are both now standard of care with class I, level of evidence A. Various local, regional, and national challenges are present, preventing equality in access to care for many patients. France is a developed country with a centralized national health care system accessible for all citizens. This article discusses current challenges in the implementation of the delivery of stroke care and some solutions that are being evaluated by the medical community., (Copyright © 2018 Elsevier Inc. All rights reserved.)