Department of Pediatrics.
Department of Pediatrics, Division of Pediatric Hematology-Oncology, Hassenfeld Children's Hospital at NYU Langone Health, NYU Grossman School of Medicine, New York, New York.
Hosp Pediatr. 2023 Dec 1;13(12):e377-e383. doi: 10.1542/hpeds.2023-007174.
Communication skills are critical to pediatric practice, but few pediatric residency programs provide formal communication skills education. Pediatric residents often lack confidence in these skills. We hypothesized that a simulation-based communication skills course would improve resident confidence in the skills required for serious illness conversations with patients/families.
In collaboration with multidiscipline VitalTalk-trained faculty, we developed PedsTalk, a communication skills course for pediatric residents based on the VitalTalk framework. In PedsTalk, faculty/peers offered real-time coaching during simulation sessions with actors. Resident participants self-rated confidence in 9 communication skills using a 5-point Likert scale before, immediately after, and 4 months after course participation, with course nonparticipants serving as controls. Responses were analyzed by using Friedman tests and Wilcoxon rank tests. Thematic analysis was conducted to identify themes among free-text responses.
Twenty-seven pediatric residents participated in PedsTalk, 11 of whom completed survey assessments at all timepoints. Eleven course nonparticipants served as controls. Over time, participants' confidence in the following communication skills was retained or significantly improved: "difficult conversations" (P < .001), "recognizing emotion" (P < .01), "using silence" (P < .008), "headline statements" (P < .001), eliciting "VALUES" (P < .001), and asking "permission to continue" (P < .001). Over time, controls had significant improvements in confidence in 2 skills: headline statements (P < .014) and eliciting "VALUES" (P < .031).
PedsTalk is a novel approach to communication skills education in pediatric residency. Participation improved residents' confidence in 6 communication skills, including overall confidence in having difficult conversations. Although confidence in some skills may naturally develop through clinical experiences, PedsTalk further enhances communication skills education among trainees.
沟通技巧对于儿科实践至关重要，但很少有儿科住院医师培训计划提供正式的沟通技巧教育。儿科住院医师通常对这些技能缺乏信心。我们假设基于模拟的沟通技巧课程将提高住院医师对与患者/家属进行严重疾病对话所需技能的信心。
与多学科 VitalTalk 培训教员合作，我们根据 VitalTalk 框架为儿科住院医师开发了 PedsTalk 沟通技巧课程。在 PedsTalk 中，教员/同行在与演员进行模拟会议期间提供实时指导。参与者在课程参与前后和课程参与后 4 个月使用 5 点 Likert 量表自我评估 9 项沟通技巧的信心，非参与者作为对照组。使用 Friedman 检验和 Wilcoxon 秩检验分析响应。通过主题分析确定自由文本响应中的主题。
27 名儿科住院医师参加了 PedsTalk，其中 11 名在所有时间点完成了调查评估。11 名非参与者作为对照组。随着时间的推移，参与者在以下沟通技巧方面的信心得到保留或显著提高：“困难对话”（P <.001）、“识别情绪”（P <.01）、“使用沉默”（P <.008）、“头条声明”（P <.001）、引出“价值观”（P <.001）和询问“继续的许可”（P <.001）。随着时间的推移，对照组在 2 项技能方面的信心有显著提高：头条声明（P <.014）和引出“价值观”（P <.031）。
PedsTalk 是儿科住院医师培训中沟通技巧教育的一种新方法。参与提高了住院医师对 6 项沟通技巧的信心，包括进行困难对话的整体信心。尽管某些技能的信心可能会通过临床经验自然发展，但 PedsTalk 进一步增强了学员的沟通技巧教育。
