# To assess the level of knowledge, attitude, and practice of communication among ICU trainees across India, TALK ICU SURVEY

## TL;DR

This survey assesses communication skills among ICU trainees in India, finding a lack of formal training and significant gaps in knowledge and practice.

## Contribution

The study provides insights into communication challenges and training needs among Indian ICU trainees.

## Key findings

- Only 50% of trainees had formal communication training, and only 14% knew the SPIKES protocol.
- Trainees with formal training performed better in communicating medical errors and bad news.
- Barriers to effective communication included family education level, language, and doctor burnout.

## Abstract

Effective communication skills are the key component in the doctor-patient relationship. We aimed to assess the level of knowledge of communication among the ICU trainees across India.

We conducted a nationwide survey. The survey comprised diverse aspects like breaking bad news, taking informed consent, communicating a medical error, reasons for multidisciplinary conflicts, and end-of-life care (EOLC) policies.

A total of 146 responses were analysed. The predominant age group was 31–40 yrs. (72.60%) with female preponderance (63.7%). Most trainees had 1–5 years of work experience, had post-graduation in anesthesiology, and enrolled for the Indian Diploma in Critical Care Medicine. Only around 50% had formal communication training. Barriers to counselling were the education level of the family (78.76%), language (43.15%), burnout of the treating doctor (43.15%), and the severity of illness (41.09%). The majority were aware of the EOLC policy (59.58%) and felt this was the need of the hour (96.57%). The SPIKES (Setting up, Perception, Invitation, Knowledge, Emotions with Empathy, and Strategy or Summary) protocol was mentioned only by 13.98% of trainees as a strategy for communication. Trainees who had received formal training in communication had more experience in communicating a medical error and had less difficulty in breaking bad news as compared to trainees with no formal training in communication (p < 0.05). Reasons for interdisciplinary conflicts among doctors included communication and knowledge gaps, ego, and differences of opinion. The trainees suggested strategies for improving communication skills, including formal training, real-time communication experience under supervision, the use of simulation, and adherence to standard operating procedures.

The current survey revealed that trainees lacked adequate knowledge and skills in communication. These findings can help design the training curriculum focused on communication skills.

The online version contains supplementary material available at 10.1186/s12909-025-07977-z.