Residents' Communication With Attendings About Uncertainty: A Single-Site Longitudinal Survey.

Area of Science:

• Medical Education
• Pediatric Residency Training
• Physician Communication

Background:

• Managing uncertainty is crucial for pediatric residents.
• Effective communication of uncertainty with attending physicians presents challenges.
• Understanding residents' communication goals and perceptions is needed.

Purpose of the Study:

• Assess changes in residents' self-perceived communication efficacy regarding uncertainty.
• Evaluate residents' perceptions of attending physicians' willingness to discuss uncertainty.
• Identify residents' goals and challenges in communicating uncertainty.

Main Methods:

• A 3-year survey study (2018-2021) involving two cohorts of pediatric residents at a US children's hospital.
• Hierarchical linear modeling used to analyze changes in communication efficacy over time.
• Open-ended responses were coded to identify communication goals and challenges.

Main Results:

• Residents' communication efficacy and perceived attending physician willingness to discuss uncertainty significantly increased over time.
• Residents balanced multiple goals (task, identity, relational) when communicating uncertainty.
• Key challenges included residents' desire to appear competent and attending physicians' reluctance to discuss uncertainty.

Conclusions:

• Pediatric residents' confidence in communicating uncertainty grows, but these conversations remain complex.
• Training in communication about uncertainty is beneficial for both residents and attending physicians.
• Addressing communication challenges can enhance the learning environment and patient care.