M. Harmelink MA

PhD student
Main activities
Medical communication
Focus of research

In the NICU, PICU and ICU, difficult decisions are made about the possible redirection of care. Because patients in the NICU and PICU are not able to make treatment decisions and most critically ill patients in the ICU lack the capacity to make such decisions, decision-making almost always involves surrogate decision-makers. The cognitive and emotional complexity of this kind of decision-making raises the question of how to best involve and communicate with family members in the decision-making process. As each person and each situation is different, this calls for customization. This customization is mostly learned on the job by trial and error. For staff members, there is little to no opportunity to observe colleagues to learn from each other’s practices. There is also little to no opportunity for doctors to use recordings of their own conversations as a basis for developing one’s own skills.

In this thesis project I aim to contribute to the concrete improvement of complex communication with family members within the NICU, PICU and ICU by gaining insight into how doctors and family members communicate about the possible redirection of care, and about the (underlying) dilemmas. These insights will be used as a basis for (a) publishing in (scientific/professional) journals and talks at conferences, for (b) making an interactive video database with best practices which will be used as a training tool, for (c) developing a training program for fellows, and for (d) developing a reflection tool for medical and nursing staff.