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Some difficulties encountered in teaching physician‐parent communication in a pediatric emergency department

In an attempt to increase physician-parent communication in cases of a child's emergency hospitalization, an informational protocol was developed with 10 topics to be discussed and checked off by the physician. Compliance was sporadic, with only 130 protocols completed during the first month, despite measures to improve its use. During the seven-month study period there were 2161 admissions, but only 466 protocols completed (21.5%). We excluded 143 forms because of errors in completion. The remaining 323 forms were analyzed for educational level of the physicians, topics omitted, patient diagnosis, and physician's rating of parent sophistication. Compliance in discussing each topic ranged from 77 to 93%. Attending physicians discussed all topics less than trainee physicians. All physicians discussed guilt feelings least (P < 0.001). Guilt was discussed 55 and 62% of the time when the diagnosis was poisoning or chronic disease, respectively. Topics discussed were unrelated to parental sophistication. This protocol was unhelpful in improving communication.