Recognizing Communication as a Procedural Skill in Neonatology

Many of the ethical challenges that arise in the neonatal intensive care unit (NICU) stem from communication difficulties between families and clinicians. Parents in the NICU face tremendous stress, including separation from their infants, uncertainty about clinical outcomes, and fear for the future; they require clear and compassionate communication from clinicians to build trust and engage in shared decision-making. In this review, we explore how trauma that parents experience in the NICU shapes their communication needs, examine the role of communication in providing trauma-informed care, describe competencies in communication for neonatal clinicians, and depict established and novel models of communication training. We propose that communication should be thought of as a core clinical skill for neonatologists, and similar to procedural skills, requires dedicated training and practice to improve.