Professionalism and Communication Education in Pediatric Critical Care Medicine: The Learner Perspective.
OBJECTIVE
Communication and professionalism are often challenging to teach, and the impact of the use of a given approach is not known. We undertook this investigation to establish pediatric critical care medicine (PCCM) trainee perception of education in professionalism and communication and to compare their responses from those obtained from PCCM fellowship program directors.


METHODS
The Education in Pediatric Intensive Care (E.P.I.C.) Investigators used the modified Delphi technique to develop a survey examining teaching of professionalism and communication. After piloting, the survey was sent to all 283 PCCM fellows in training in the United States.


RESULTS
Survey response rate was 47% (133 of 283). Despite high rates of teaching overall, deficiencies were noted in all areas of communication and professionalism assessed. The largest areas of deficiency included not being specifically taught how to communicate: as a member of a nonclinical group (reported in 24%), across a broad range of socioeconomic and cultural backgrounds (19%) or how to provide consultation outside of the intensive care unit (17%). Only 50% of fellows rated education in communication as "very good/excellent." However, most felt confident in their communication abilities. For professionalism, fellows reported not being taught accountability (12%), how to conduct a peer review (12%), and how to handle potential conflict between personal beliefs, circumstances, and professional values (10%). Fifty-seven percent of fellows felt that their professionalism education was "very good/excellent," but nearly all expressed confidence in these skills. Compared with program directors, fellows reported more deficiencies in both communication and professionalism.


CONCLUSIONS
There are numerous components of communication and professionalism that PCCM fellows perceive as not being specifically taught. Despite these deficiencies, fellow confidence remains high. Substantial opportunities exist to improve teaching in these areas.
Division of Pediatric Critical Care, Duke Children's Hospital, Durham, NC. Electronic address: David.turner@duke.edu.
David A
DA
Turner
Pediatric Critical Care, Monroe Carroll Children's Hospital, Vanderbilt University, Nashville, Tenn.
Geoffrey M
GM
Fleming
Pediatric Critical Care, University of Alabama Medical Center, Birmingham, Ala.
Margaret
M
Winkler
Department of Pediatrics, Critical Care, Medical College of Wisconsin, Milwaukee, Wis.
K Jane
KJ
Lee
Pediatric Critical Care, University of Pittsburgh Medical Center, Pittsburgh, Pa.
Melinda F
MF
Hamilton
Duke Clinical Research Institute, Durham, NC.
Christoph P
CP
Hornik
Pediatric Critical Care, Children's Healthcare of Atlanta, Emory University, Atlanta, Ga.
Toni
T
Petrillo-Albarano
Pediatric Critical Care, Rainbow Babies and Children, Cleveland, Ohio.
Katherine
K
Mason
Pediatric Critical Care, Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute, Torrance, Calif.
Richard
R
Mink
D001291:Attitude of Health Personnel; D003142:Communication; D003422:Critical Care; D003479:Curriculum; D006801:Humans; D010372:Pediatrics / Q000193:education*; D000068616:Professionalism / Q000193:education*; D013337:Students, Medical; D011795:Surveys and Questionnaires; D014481:United States
communication; competency; evaluation; fellowship training; graduate medical education; pediatric; professionalism