Pediatric residents’ perceptions of communication competencies: Implications for teaching

Figures & data

Table

Practice points

Medical organizations worldwide require competency in communication skills. Pediatric communication competencies are unique, and little is known about pediatric residents’ attitudes and perceptions regarding these skills. The pediatric residents we studied reported confidence in basic communication skills such as interviewing, listening, building rapport, and demonstrating caring and empathy, yet they lacked confidence in advanced communication competencies relevant to pediatrics including the ability to discuss end-of-life issues, speaking with children about serious illness, giving bad news, dealing with the ‘difficult’ patient or parent, cultural awareness/sensitivity, understanding psychosocial aspects of care, and understanding patients’ perspectives. Our measurement scales may be used to add to the evaluation of the residency program, and may provide suggestions for pediatric curricular content in core and advanced communication skills.

Figure 1. Percent of housestaff reporting the development of communication skills as important and percent reporting confidence in their skills (N = 89).

Table 1.  Representative items and characteristics of questionnaire

Scale and selected questionnaire items	Likert scale definitions	Scale Alpha Coefficient (N = 89)	Number of Items
Importance scale*	1 Very low importance	0.92	15
How important is it for housestaff to develop skills in the following areas:	2 Low importance
a. Ability to communicate effectively with patients.	3 Moderate importance
b. Understanding patients’ perspectives on their illness	4 High importance
c. Giving bad news about a patient's illness to the patient and family.	5 Very high importance
d. Dealing with the ‘difficult’ patient or parent.
Confidence scale*	1 Not at all confident	0.90	15
How confident do you feel about your skills in each of these areas:	2 A little confident
a. Ability to demonstrate empathy and caring with patients.	3 Somewhat confident
b. Ability to discuss end-of-life issues with patients and/or family.	4 Rather confident
c. Understanding psychosocial aspects of patient care	5 Very confident
d. Cultural awareness/sensitivity

*Questionnaire items for the Importance and Confidence Scales are identical while the Likert anchors are different.

Table 2.  Communication skills survey scale comparisons

Scale	By post graduate year		By previous communication skill training		By gender		By age (Pearson correlation)
Variables	F	Sig.	F	Sig.	F	Sig.	r	Sig.
Communication skills importance	1.897	0.157	4.035	0.048*	0.245	0.622	0.041	0.715
Communication skills confidence	7.622	0.001*	0.093	0.762	0.248	0.620	0.201	0.077

*Significant.

Table 3.  Percent of housestaff reporting feeling rather or very confident in each communication skill (N = 89)

Communication competency or skill	Percent reporting feeling rather or very confident
Ability to discuss end-of-life issues with patients and/or family	19
Speaking to children about serious illness	23
Giving bad news about a patient's illness to the patient and family	27
Dealing with the ‘difficult’ patient or parent	39
Cultural awareness/sensitivity	45
Understanding psychosocial aspects of patient care	52
Understanding patients’ perspectives on their illness	53
Developing awareness of personal reactions to patients	60
Interviewing adolescents	65
Interviewing children	75
Listening skills	78
Building rapport with patients	81
Interviewing parents	83
Ability to communicate effectively with patients	84
Ability to demonstrate empathy and caring with patients	87

Table 4.  Percent of housestaff indicating presence of program supports (N = 89)

Program supports	Percent* agreeing or strongly agreeing	Percent neutral	Percent disagreeing or strongly disagreeing
I receive constructive feedback about my relationships with other team members	50	32	18
I receive constructive feedback about my relationships with patients	49	30	22
I have adequate time to interact with my patients	27	32	41
My department rewards good patient-doctor communication skills by housestaff	25	38	38
Formal training in effective communication with patients is available to me	10	39	51

*Percents may not add to 100 due to rounding.