Pediatric residents’ perceptions of communication competencies: Implications for teaching

Abstract

Background: Medical regulatory organizations worldwide require competency in communication skills. Pediatric communication competencies are unique, and little is known about pediatric residents’ perceptions regarding these skills.

Aim: The purpose of this study was to examine pediatric residents’ attitudes about communication skills, their perceptions of the importance of learning 15 specific communication skills relevant to pediatrics, confidence in these skills, and relevant program supports.

Methods: We developed a 47-item cross-sectional questionnaire to study pediatric residents’ attitudes and perceptions regarding communication competencies. 104 pediatric housestaff in a university-affiliated program in the US were asked to complete the questionnaire. Scale variables were created and evaluated for reliability. Data were analysed using descriptive and univariate statistics.

Results: Response rate was 86% (89/104). Cronbach's alpha reliabilities of the Importance Scale (r = 0.92) and Confidence Scale (r = 0.90) were excellent. Ninety nine percent of the participants agreed that learning to communicate effectively with patients was a priority. All agreed it is important to demonstrate empathy and caring, and to teach medical students to communicate effectively with patients. Pediatric residents agreed that the 15 communication competencies studied were important to learn. Most reported confidence in core communication competencies (interviewing, listening, building rapport, demonstrating caring and empathy), but only half or fewer were confident in 7 more advanced communication skills (ability to discuss end-of-life issues, speaking with children about serious illness, giving bad news, dealing with the ‘difficult’ patient/parent, cultural awareness/sensitivity, understanding psychosocial aspects, and understanding patients’ perspectives). Few reported the availability of relevant program supports for learning these skills.

Conclusions: Pediatric residents perceive communication competencies as important and a priority for learning, yet report a lack of confidence in advanced communication skills and insufficient program supports. Our measurement scales can add to the evaluation of residency programs, and may provide suggestions for pediatric curricular content in core and advanced communication skills.

Notes

Notes

A copy of the questionnaire is available upon request from Elizabeth A. Rider, MSW, MD; E-mail: [email protected].

Additional information

Notes on contributors

Elizabeth A. Rider

ELIZABETH A. RIDER, MSW, MD is Director of Academic Programs, Institute for Professionalism and Ethical Practice, Children's Hospital; Director of Programs for Communication Skills, Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital; and Assistant Professor of Pediatrics, Harvard Medical School, Boston, MA USA. She teaches and consults nationally and internationally on teaching and assessing communication competencies, reflective practice, relationship-centered care, and medical education program development.

Kevin Volkan

KEVIN VOLKAN, EdD, PhD, MPH is Professor of Psychology at California State University Channel Islands, Camarillo, CA and formerly Director of Assessment at Harvard Medical School where has taught extensively on leadership and assessment in medical education. His research interests include the creation and validation of objective structured clinical examinations and assessment of attitudes, skills, and knowledge among medical students and residents.

Janet P. Hafler

JANET P. HAFLER, EdD is Professor, Tufts University School of Medicine, Boston, MA. She has extensive experience teaching faculty, residents, and students about curriculum, teaching, and evaluation. Her current interests are in the area of developing resident-as-teacher programs, developing faculty members as educators and the scholarship of education.