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American Academy of Pediatrics
Research Articles

Communication Skills and Practices Vary by Clinician Type

Amy H. Jones, Marni B. Jacobs and Tessie W. October
Hospital Pediatrics April 2020, 10 (4) 325-330; DOI: https://doi.org/10.1542/hpeds.2019-0262
Amy H. Jones
aDepartments of Critical Care Medicine and
bDepartment of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
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Marni B. Jacobs
bDepartment of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
cBiostatistics and Study Methodology, Children’s Research Institute, Children’s National Hospital, Washington, District of Columbia; and
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Tessie W. October
aDepartments of Critical Care Medicine and
bDepartment of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
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Abstract

OBJECTIVES: Unscheduled admission to the PICU is a stressful experience for families. During the admission process, families communicate with 4 types of clinicians (resident, nurse practitioner, fellow, and attending physician). All clinicians must manage family stress while communicating concise, accurate information. The manner and variability in how different clinicians communicate with families at the time of PICU admission is not yet known.

METHODS: We performed a prospective observational study to evaluate communication patterns of various clinician types, including the length of communication encounters and the number of provider interruptions at the time of admission to the PICU during a 3-month period. All nonscheduled admissions to the PICU were eligible for enrollment. The admission intake was audio recorded and directly observed.

RESULTS: We observed 45 different family–clinician interactions for a total of 19 unique family encounters (48% of eligible admissions). Residents and nurse practitioners spent the most time communicating with families (14.3 and 19 minutes, respectively) compared with fellows (7.3 minutes) and attending physicians (6.6 minutes). Residents were frequently interrupted by pages and phone calls (64% of interactions) and spoke at a higher reading level than all other clinician types (P = .03; 95% confidence interval 74.6–83.9). Qualitatively, residents had more challenges coping with distractions, acknowledging parental emotions, and aligning with parental goals compared with other clinician types.

CONCLUSIONS: Resident trainees spend significantly more time with families and, during this time, are burdened with frequent interruptions. In this stressful communication environment, residents encounter more barriers to communication and may require additional communication skills to manage relaying complex information while simultaneously responding to parental emotions.

  • Copyright © 2020 by the American Academy of Pediatrics
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Hospital Pediatrics: 10 (4)
Hospital Pediatrics
Vol. 10, Issue 4
1 Apr 2020
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Communication Skills and Practices Vary by Clinician Type
Amy H. Jones, Marni B. Jacobs, Tessie W. October
Hospital Pediatrics Apr 2020, 10 (4) 325-330; DOI: 10.1542/hpeds.2019-0262

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Communication Skills and Practices Vary by Clinician Type
Amy H. Jones, Marni B. Jacobs, Tessie W. October
Hospital Pediatrics Apr 2020, 10 (4) 325-330; DOI: 10.1542/hpeds.2019-0262
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