Purpose Few studies have examined the factors which impact the physician's ability to adequately answer parent questions. We hypothesized that when resident physicians are stressed from competing ward duties, they would be less attentive and spend less time with the patient, resulting in both physician and parent dissatisfaction with communication during the clinic visit.
Methods Over a four month period, residents and parents in our pediatric continuity clinic were asked to complete a short survey. Residents rated whether they adequately answered the parents' questions, their current level of stress and their satisfaction with their clinic encounters. Likewise, parents assessed whether the resident adequately answered their questions, their satisfaction with the visit and the amount of time spent with the physician. Multiple regression approaches assessed the relationship between resident and parent assessment of the answers to parent questions and all other variables.
Results Overall, 342 matched resident and parent surveys were returned. In the majority of surveys (66%), both the resident and the parent considered questions to be adequately answered, and only a minority (2%) concurred on the inadequacy of answers. The remainder showed discordance between parent and resident impressions. In 31%, the parent thought their questions were adequately answered but the resident did not, and in 10%, the parent did not consider their questions adequately answered, but the resident thought they were. The only independent predictor of parent dissatisfaction with the answers to their questions was less time spent with the physician, whereas resident dissatisfaction was only associated with high stress ratings (feeling pressed by other commitments and feeling that their work was interfering with their life). When residents rated their answers as inadequate, they were significantly less satisfied with the visit (3.7 ± 0.7 vs. 4.85 ± 0.4, p < .0001); however, parents remained satisfied with their clinic visit. Likewise, when parents felt that their questions were not adequately answered, their overall satisfaction was less (8.6 ± 1.4 vs. 9.9 ± .9, p < .0001), but resident satisfaction remained high.
Conclusions Residents adequately answer parent questions in the majority of pediatric patient visits. However, inadequate ratings often show discordance between resident and parent perceptions. When residents are stressed, they rate their communication lower and they are less satisfied with their continuity clinic visits, but patient satisfaction with communication and the overall clinic visit remains high.
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