Assessment of parent understanding in conferences for critically ill neonates.
Mary C Barks, Emma A Schindler, Peter A Ubel and 4 others
PMID 34130892WHAT IT FOUND
In these NICU family meetings, clinicians never used teach-back.
Open-ended questions got more detailed parent answers in 55 of 60 cases, while partial checks such as 'okay?' mostly got no response.
Key findings
01Open-ended assessments were the least common type, yet they produced elaborated parent responses in 55 of 60 cases.
02Partial checks such as 'okay?' were the most common assessment type and yielded a verbal response in only 51 of 209 cases.
03No family meeting contained a teach-back.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was a convenience sample drawn from two earlier studies. Only English-speaking parents were included, and the infants had varied neurologic conditions. A minority of transcripts, 8 of the analysed meetings, came from a study that used a question prompt list, which may have increased assessments of understanding. Most transcripts were coded by one analyst after two analysts double-coded 9 transcripts, which was 18% of the sample. Partial checks such as 'okay?' may have been conversational fillers or signals to move to the next topic, not true understanding checks. Nonverbal parent responses were not assessed, and a single meeting is not representative of all family-clinician interactions in the NICU.
Declared interests
The authors declared no competing financial interests. The article metadata lists NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that open-ended questions improve parent understanding or care decisions. The study counted what happened in recorded conferences and did not test an intervention or measure parent outcomes.