A talking map for family meetings in the intensive care unit

Objective: To describe the use of a cognitive map for navigating family meetings with surrogate decision makers of patients in an intensive care unit. • Methods: Descriptive report and discussion using an illustrative case to outline the steps in the cognitive map. • Results: The use of cognitive maps has improved the ability of physicians to efficiently perform a specific communication skill. During a "goals of care" conversation, the cognitive map follows these steps: (1) Gather the clinical team for a pre-meeting, (2) Introduce everyone, (3) Use the "ask-tell-ask" strategy to communicate information, (4) Respond to emotion, (5) Highlight the patient's voice, (6) Plan next steps, (7) Reflect on the meeting with the team. Providing this map of key communication skills will help faculty teach learners the core components of a family meeting. • Conclusion: Practicing the behaviors demonstrated in the cognitive map may increase clinician skill during difficult conversations. Improving communication with surrogate decision makers will increase the support we offer to critically ill patients and their loved ones.