By Melinda Young
Researchers asked parents of critically ill children what type of communication they appreciated and what types they found stressful. They learned how providers, case managers, and other healthcare professionals could improve their communication and patient/family education.1
“Being a practicing clinician, I saw the need to develop these communication skills myself. As a researcher, I wanted to know how to train other clinicians in these skills,” says Jennifer Walter, MD, PhD, MS, an associate professor of pediatrics and medical ethics at the University of Pennsylvania Perelman School of Medicine.
Walter found Vital Talk offered helpful tactics for improving communication skills. “The program uses simulated role play with pretend patients or parents to assess skills and tailor communication to families,” explains Walter, the attending physician with the Justin Michael Ingerman Center for Palliative Care at the Children’s Hospital of Philadelphia. “Most of the time, when we provide serious news to families, it evokes an emotional response. We may feel empathetic about someone suffering, but we don’t know how to express that.”
Training can help providers improve and update their communication style. “Many of us were trained before the last decade, and we had to learn on the job,” Walter says. “Giving clinicians the opportunity to practice skills in simulated labs, where they can’t hurt anyone, has given them a lot more confidence that they are able to meet families’ needs and can partner with families in a way that works for the individual family.”
One way to improve communication is to determine whether the person understands instructions and information. “A lot of what we train clinicians to do is ask [the family] if they understand before we provide information,” Walter says. “They may have a sophisticated understanding or a limited understanding, and you are able to hear their level of health literacy.”
These are questions to think about when assessing a family’s understanding:
- Are they asking about medication?
- Can they track the history of the disease process?
- Do they ask if their child is really sick and do not seem to understand what is happening?
- Do they think they are doing better or worse than what is happening?
“You can say, ‘That’s on target,’ or ‘I may have better information than what you had up to now. What is the best way for me to share information?’” Walter suggests.
Find out what works best for the individual. “If there are multiple family members, you may have different answers,” Walter adds. “The wife might say, ‘I want to have all the details,’ and the husband says, ‘I can’t handle it.’”
For people who do not want the details, it is best to provide a big-picture summary, with accurate and clear information that is not filled with jargon. “Allow the wife to ask questions she wants answers to,” Walter says. “A more detailed explanation may allow straightforward understanding for someone who wants all the details.”
Not using jargon in verbal or written communication is beneficial to families. “Families appreciate being asked questions and hearing information that is geared toward them,” Walter says. “When clinicians listened to them, they found it very beneficial and it helped facilitate that relationship, which allowed for more successful communication.”
REFERENCE
- Gramszlo C, Girgis H, Hill D, Walter JK. Parent communication with care teams and preparation for family meetings in the paediatric cardiac ICU: A qualitative study. Cardiol Young 2023;1-7. doi: 10.1017/S1047951123001282. [Online ahead of print].
Researchers asked parents of critically ill children what type of communication they appreciated and what types they found stressful. They learned how providers, case managers, and other healthcare professionals could improve their communication and patient/family education.
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