PC3106: Pedstalk: A Pilot Communication Skills Education Program for Pediatric Residents

Background: Communication skills are critical to pediatric training, but few residency programs provide structured communication skills education. Effective communication increases patient and family understanding of care and improves quality of life. Pediatric residents also report lacking confidence in communication skills. We hypothesized that a simulation-based communication skills training program would increase resident confidence in having challenging conversations with patients and families.

Methods: In collaboration with VitalTalk-trained Geriatrics and adult Palliative Care faculty, we developed a communication skills program for pediatric residents (PedsTalk) based on the VitalTalk framework. Pediatric faculty communication champions were identified and trained in a two-day communication skills workshop and partnered with VitalTalk-trained adult and pediatric faculty for PedsTalk. Pediatric residents completed a demographics survey and needs assessment to determine baseline communication skills experiences. A pre-course module introduced skills before a half-day of simulation with trained actors. Faculty and peers offered real-time coaching during simulations. Participants reported their confidence/lack of confidence with nine communication skills using a 5-point Likert scale before, soon after course participation, and four months after participation. Non-participants served as a control group. Baseline scores and scores at 4-month follow-up were compared between participants and controls using Mann-Whitney-U tests. Scores over time for participants were assessed using Friedman tests and for controls over time using Wilcoxon Signed Rank tests.

Results: Twenty-four trainees (~40% of the program) participated in PedsTalk. Full data for analysis was available for 11 participants and 11 controls. For participants, significant improvements or retention in skill confidence were seen for: ‘difficult conversations’ (p < 0.000), ‘using silence’ (p < 0.008), ‘headline statements’ (p < 0.000), eliciting “VALUES” (p < 0.000), and asking permission to proceed (p < 0.000) (Table 2). At 4-month follow-up, participants reported retention in confidence level among three of these skills (‘difficult conversations’, ‘headline statements’, and asking permission to proceed). Over time, controls also had significant improvements in confidence with ‘headline statements’ (p < 0.014) and eliciting “VALUES” (p < 0.031).

Conclusion: Through interdisciplinary partnership, engagement of pediatric faculty as communication champions, and simulation training, PedsTalk is a novel and sustainable approach to communication education in pediatric residency. Participating in PedsTalk improved pediatric trainees' confidence in five communication skills immediately following the intervention. Residents then reported retained confidence in three skills at 4-month follow-up. It is important to note that confidence in two skills also increased in residents who did not participate in the course. This demonstrates that while confidence in communication skills naturally develops over time through routine clinical exposures in residency, PedsTalk can augment these skills in trainees. Future directions should explore mechanisms to further improve and retain confidence in communication skills over time.