Related Experiment Video
Updated: Nov 2, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Assessment of parent understanding in conferences for critically ill neonates
Mary C Barks1, Emma A Schindler2, Peter A Ubel3
1Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA; Fuqua School of Business, Duke University, Durham, NC, USA.
Insights
Clinician assessments of understanding in critically ill infant care are common but often ineffective. Open-ended questions significantly improve parent engagement and communication, highlighting an underutilized strategy for better information exchange.
Area of Science:
- Pediatric critical care medicine
- Communication in healthcare
- Family-centered care
Background:
- Effective communication is crucial in pediatric critical care.
- Assessing parental understanding is vital for shared decision-making.
- Current communication strategies may not adequately gauge parental comprehension.
Purpose of the Study:
- To analyze the types and impact of clinician assessments of understanding during parent-clinician communication.
- To evaluate parent responses to different assessment methods.
- To identify strategies for enhancing communication effectiveness.
Main Methods:
- Audio recordings of family conferences for critically ill infants with neurologic conditions were analyzed.
- A directed content analysis approach was used to identify clinician assessments and parent responses.
- Assessments were categorized, and parent responses were classified as absent, yes/no, or elaborated.
Main Results:
- 374 clinician assessments of understanding were identified in 50 conferences.
- Most assessments (56%) were partial (e.g., "okay?"), and only 16% were open-ended.
- Open-ended questions led to elaborated parent responses 92% of the time, while partial assessments rarely elicited verbal responses.
Conclusions:
- Most clinician assessments of understanding are closed-ended or partial, limiting elaborated parent responses.
- Open-ended assessments are an effective but underutilized method to boost parent engagement.
- Clinicians should use open-ended statements to improve understanding and identify information needs.
Objectives:
This study aimed to characterize the use and impact of assessments of understanding in parent-clinician communication for critically ill infants.
Methods:
We enrolled parents and clinicians participating in family conferences for infants with neurologic conditions. Family conferences were audio recorded as they occurred. We used a directed content analysis approach to identify clinician assessments of understanding and parent responses to those assessments. Assessments were classified based on an adapted framework; responses were characterized as "absent," "yes/no," or "elaborated."
Results:
Fifty conferences involving the care of 25 infants were analyzed; these contained 374 distinct assessments of understanding. Most (n = 209/374, 56%) assessments were partial (i.e. okay?); a minority (n = 60/374, 16%) were open-ended. When clinicians asked open-ended questions, parents elaborated in their answers most of the time (n = 55/60, 92%). Approximately three-quarter of partial assessments yielded no verbal response from parents. No conferences included a teach-back.
Conclusions:
Although common, most clinician assessments of understanding were partial or close-ended and rarely resulted in elaborated responses from parents. Open-ended assessments are an effective, underutilized strategy to increase parent engagement and clinician awareness of information needs.
Practice Implications:
Clinicians hoping to facilitate parent engagement and question-asking should rely on open-ended statements to assess understanding.
More Related Videos
Related Concept Videos
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:24Nursing Process for Patient and Caregiver Teaching I: Assessment and Diagnosis
It is critical to determine the patient's learning needs during the assessment. Determination of learning needs compounds data...
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
01:20Nursing Process for Patient and Caregiver Teaching III: Evaluation and Documentation
Nurses can use several methods to evaluate patient outcomes. For example, oral questions can assess cognitive learning,...
01:25Role of Communication in the Nursing Process II: Planning and Implementation