• Lori Brand Bateman, Nancy M Tofil, Marjorie Lee White, Leon S Dure, Jeffrey Michael Clair, and Belinda L Needham.
• Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA loribateman@uabmc.edu.
• Am J Hosp Palliat Care. 2016 Dec 1; 33 (10): 935-941.

ObjectiveThe objective of this exploratory study is to describe communication between physicians and the actor parent of a standardized 8-year-old patient in respiratory distress who was nearing the end of life.MethodsThirteen pediatric emergency medicine and pediatric critical care fellows and attendings participated in a high-fidelity simulation to assess physician communication with an actor-parent.ResultsFifteen percent of the participants decided not to initiate life-sustaining technology (intubation), and 23% of participants offered alternatives to life-sustaining care, such as comfort measures. Although 92% of the participants initiated an end-of-life conversation, the quality of that discussion varied widely.ConclusionFindings indicate that effective physician-parent communication may not consistently occur in cases involving the treatment of pediatric patients at the end of life in emergency and critical care units.Practice ImplicationsThe findings in this study, particularly that physician-parent end-of-life communication is often unclear and that alternatives to life-sustaining technology are often not offered, suggest that physicians need more training in both communication and end-of-life care.© The Author(s) 2015.

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