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Methods: We surveyed all HCPs at a large pediatric referral center by e-mail distribution of an anonymous link via Qualtrics. Relevant subscale items of the Collaborative Practice Assessment Tool (CPAT) were adapted and combined with novel questions drawing from literature on patient-centered communication. The 32-item survey was divided into seven content domains: collaboration, communication strategies, goals of care, quality of life, decision-making, conflict and self-rated confidence in communication skills. Item responses were rated on a 4-point Likert scale; where score≥ 3 suggests inadequate communication. A summation score was generated for each domain. Descriptive analyses were performed. Poisson regressions tested the association between predictors (eg primary role, location, experience, CCI exposure) and summation scores of each domain. Statistical significance was set at p-value< 0 …