Hands-on device training improves pediatric resident communication skills

New research from Advocate Health's Advocate Aurora Research Institute suggests that giving pediatric residents hands-on training with medical devices may help them communicate more effectively with the families of children frequently hospitalized in pediatric units. 

For the study, published recently in Hospital Pediatrics, a journal of the American Academy of Pediatrics, researchers developed a training program focused on five types of medical devices commonly used by hospitalized children with complex medical needs - central lines, chest tubes, feeding devices, tracheostomies and cerebrospinal fluid shunts. 

Researchers not only looked at what residents learned from the training but also surveyed the caregivers of the pediatric patients on how well the doctors communicated. 

Children with medical complexity often have multiple chronic health conditions and may depend on medical equipment as part of their everyday care. These patients often account for up to half of children admitted to tertiary care hospitals, yet pediatric residents - often among the first physicians to care for them - have reported feeling inadequately prepared for their needs. 

Kelci Butler, D.O., lead author, assistant professor of pediatrics, Wake Forest University School of Medicine in Winston-Salem, North Carolina and pediatric hospitalist at Advocate Children's Hospital in Park Ridge, Illinois

"We wanted to bridge that gap by developing a training that addresses this issue and in turn also helps the residents communicate with patients and their families," she added. 

The curriculum included five one-hour, in-person workshops combining instruction with hands-on simulation. Physicians, advanced practice clinicians, nurses and respiratory therapists served as instructors, allowing residents to learn directly from clinicians with experience using the devices. Sessions were conducted in small groups of no more than 10 residents per instructor. 

The curriculum was implemented for first-year pediatric residents at both the Oak Lawn and Park Ridge campuses of Advocate Children's Hospital in Illinois. All 28 first-year residents at the two sites elected to participate in the study. Researchers also included a historical comparison group of 11 residents who had not received the training. 

Researchers then collected 253 caregiver surveys assessing how well residents communicated before and after the educational intervention and in the historical comparison group. They found the average communication score increased after the training, from 4.844 to 4.934 on a five-point scale. 

Of the 14 categories evaluated, four showed significant increases. Caregivers gave residents higher marks for communicating in understandable terms, confirming that the family understood the information, encouraging questions and discussing next steps and follow-up plans. 

The researchers also compared residents who completed the curriculum with the historical group who had not received the training. That analysis showed significant gains in several communication areas among residents exposed to the training, supporting the idea that the improvements may be associated with intentional skills training rather than simply gaining more experience during residency. 

The findings are particularly relevant because knowing how to manage medical technology is only one piece of caring for medically complex children, Butler said. A physician also needs to be able to explain what is happening, make sure families understand the care plan, encourage questions and clearly discuss what happens next. The study suggests that targeted education around medical devices may help develop some of those communication skills. 

Caregivers were directly involved in evaluating the residents through a modified 14-item Communication Assessment Tool. Researchers contacted caregivers during the child's hospitalization, and participation was voluntary. The researchers noted that obtaining feedback in real time provided a perspective on resident communication that can be difficult to capture through traditional medical education assessments. 

"We value the family's perspective in all our patients' care, but especially for these medically complex children," Butler said. 

Researchers say next steps would be to evaluate such a training in other hospitals and with a larger sample size. And while this focused on medical devices, researchers acknowledged it may be useful to look at how training impacts resident knowledge and communication in other examples of medically complex patients. 

Still, the researchers say the results underscore the potential value of involving patients and families more directly in training physicians. Future educational approaches could provide residents with more individualized caregiver feedback and potentially engage caregivers as educators who can help physicians better understand the practical challenges families face. 

"Caregivers not only want highly trained physicians they can trust, but they also want someone who has empathy, involves them in discussions about their child's care and is skilled at communication," Butler said. 

The work also underscores the value of collaboration between clinicians and researchers across Advocate Health, connecting the Advocate Aurora Research Institute, the Center for Child and Family Research and the Center for Prevention Science in Child and Family Health. The partnership creates opportunities to bring family-centered research into everyday clinical practice, while also launching research that reflects the real-life experiences of the families across the Advocate Health footprint. 

The study is scheduled to appear in the January 2027 issue of Hospital Pediatrics. The authors reported no relevant conflicts of interest or funding for the study.