Pedstalk: Communication Skills Training for Pediatric Residents

Background: Communication skills are a critical, but often neglected, component of pediatric training. When clinicians communicate effectively, patients and families retain more information, have greater trust in providers, and have improved quality of life. Communication skills development and competency must begin during training, as emphasized by the ACGME. However, few formal educational models exist and pediatric residents report lacking confidence communicating during difficult conversations or distressing encounters. In partnership with adult medicine communication experts, we developed an innovative program utilizing in-situ simulation and coaching to teach communication skills to pediatric faculty and residents. We hypothesize that training these providers will result in an empowering and sustainable model for communication education in pediatric residency.

Methods: At a single institution, 11 pediatric faculty received VitalTalk communication training by adult medicine VitalTalk-trained facilitators. Two of these pediatric faculty completed advanced VitalTalk coursework to become facilitators. The newly trained pediatric facilitators will host a 3-hour educational program for pediatric residents to develop communication skills. This program utilizes in-situ simulation with standardized patients and mock pediatric cases, adapted by adult medicine facilitators, that involve difficult conversations involving serious illness. Faculty, peer residents, and standardized patients will provide real-time feedback (“coaching”) for learning purposes. Approximately 30-35 residents will complete this intervention. Pre-, post-, and 4-month follow-up surveys will assess perceived self-efficacy in communication skills and clinical application of skills. Implementation outcomes will be used to assess the intervention; surveys will include a 5-point Likert scale and write-in responses. Comparison of Likert scores will be assessed using Mann-Whitney non-parametric t-tests to examine statistical significance and Cohen d statistic to examine effect size. Write-in responses will be coded for thematic analysis by authors. Data will be compared among respondents using unique identifiers as well as between post-graduate years. Residents who cannot attend the intervention will act as controls. Based on population size, two-way ANOVA or Kruskal-Wallis test will be applied. Linear regression modeling will be used to control for effects of other factors beyond the intervention.

Results: N/A

Conclusion: Effective communication in medicine is a clinical competency with unique challenges in pediatrics, requiring formal didactic and active learning education that should begin in training. Although pediatric residency programs have employed simulation training and coaching for various purposes, our novel program utilizes both learning modalities to address the notable gap in communication skills education. Designed in partnership with adult medicine communication experts, our program offers a model for collaboration between pediatric and adult medicine colleagues for similar efforts in faculty development and resident education. Furthermore, by training pediatric faculty as VitalTalk facilitators, this project establishes a sustainable model for resident education. As few pediatric residency programs have established communication skills training programs, we anticipate our novel approach will be of significant interest.