281 - Physician perspectives on communication quality in pediatric care

Poster Number: 281
Publication Number: 281.1646

Background: High quality communication is an essential component of high quality pediatric care. Little is known about provider perceptions of communication quality.

Objective: We sought to explore physician perspectives on communication quality in a variety of pediatric contexts. We hoped to learn how physicians 1) define and describe high quality communication; 2) define and describe low quality communication; and 3) describe the communication skills training they received.

Design/Methods: We conducted semi-structured interviews with pediatric physicians over a 4-month period. Purposive sampling was conducted to ensure a broad sampling of physicians from multiple subspecialties and practice settings, and interviews were conducted until thematic saturation was reached. An interview guide was created based on existing literature and grounded in phenomenology to capture perspectives relating to the following four domains: 1) Experiences with high quality communication; 2) Experiences with low quality communication; 3) Barriers to communication; and 4) Communication skills training. Interviews were then transcribed and analyzed by two authors for key themes.

Results: Eleven clinicians enrolled in our study. Participants represented 9 sub-specialties and ranged in age from 37-74, with 63% male and 91% white. Following thematic analysis, four primary themes were identified: High Quality Communication (table 1); Low Quality Communication (table 2); Communication Factors and Barriers (table 3); and Types of Communication Education. Participants perceive relationship building and trust to be key aspects of high quality communication, with family understanding as a key marker of high quality communication. They described barriers to high quality communication including distractions, time constraints, team dysfunction, and language and cultural barriers. They linked communication quality to physician wellness and noted limited formal communication skills training.

Conclusion(s): Participants identified information transfer as among the most important aspects of communication quality, often neglecting bidirectional information exchange and shared decision-making. Participants often lacked formal communication skills training which may make it especially difficult for them to navigate common barriers such as language and cultural differences, lack of time, and interprofessional dysfunction. We propose that formal communication skills training may help with many of these challenges and may also enhance physician wellness while improving patient care.