Duke University Medical Center
Children’s Hospital of Pittsburgh
Medical College of Wisconsin
Children’s Healthcare Of Atlanta
Rainbow Babies and Children’s Hospital
Vanderbilt Children’s Hospital
Montefiore Medical Center
The Children’s Hospital of Alabama
Harbor UCLA Medical Center, for the Education in Pediatric Intensive Care (EPIC) Investigators
Introduction: Communication and professionalism are crucial elements of graduate medical education that are often challenging to teach, and the impact of a given approach is not known. We undertook this investigation to establish PCCM trainee perception of education in professionalism and communication.
Hypothesis: PCCM Fellows will report numerous areas for educational improvement in professionalism and communication.
Methods: The Education in Pediatric Intensive Care(E.P.I.C.) Investigators used the modified Delphi technique to develop a survey addressing the teaching of professionalism and communication. After development and piloting, the survey was sent to 283 PCCM fellows.
Results: Survey response rate was 47% (133/283). Programs of respondents had a median[range] of 10 [2-20] fellows, 15 [2-40] faculty and 44 [15-94] ICU beds. Deficiencies were noted in all areas of communication assessed. The largest areas of deficiency included that trainees reported not being specifically taught how to communicate: as a member of a non-clinical group (reported in 25%), across a broad range of socioeconomic and cultural backgrounds (19%), with patients and families (15%) or how to provide consultation outside of the ICU (17%). Only 50% rated education in communication as ‘very good’ or ‘excellent,’ and 12% rated it as ‘minimal.’ Despite these deficiencies, 84% of fellows felt ‘somewhat’ or ‘very confident’ in their communication abilities. For professionalism, deficiencies in fewer areas were noted. Fellows reported not being taught: accountability (12%), conducting a peer review (12%), and handling potential conflict between personal beliefs, circumstances, and professional values (10%). Only 57% of fellows feel that their education in professionalism is ‘very good’ or ‘excellent,’ but 87% feel ‘somewhat or very confident’ in professionalism skills.
Conclusions: There are components of communication and professionalism that PCCM fellows perceive as not being specifically taught. Despite these deficiencies, fellow confidence remains high. Opportunities exist to improve teaching in these areas, and an important future investigation is the relationship between confidence and competence in professionalism and communication.