When admitted to the hospital, Black and Latin(x) children are at greater risk of medical errors, surgical complications, longer, more-costly hospital stays, and mortality compared to White children. Although many factors play a role, poor clinician communication likely contributes to these disparities in health outcomes. Much of the communication between clinicians and parents or family members (i.e., “caregivers”) of hospitalized children occurs during a bedside rounding practice called “family-centered rounds.” To-date, no investigator has examined racial/ethnic disparities in the quality of clinician-caregiver communication during family- centered rounds. The aim of this study is to assess racial and ethnic differences in subjective and objective measures of communication quality during family-centered rounds using caregiver surveys and audio recordings of these encounters. Further, we will explore the relationship between communication quality and disparities in hospital outcomes, including length of stay, pain and symptom control, adverse events, and risk of readmission. This study extends the work of the parent study (REACH Project 2 of U54--REACH Equity, “The effect of a clinician communication coaching intervention on racial disparities in the quality of communication in cardiology encounters”) to a different clinical setting (ambulatory vs. inpatient) and population (adult vs. pediatric), applying similar methodology to assess communication quality. The aims of this project align with the REACH Equity theme by focusing on communication quality in the clinical encounter—a key component of patient-centered care for which racial and ethnic disparities are well-documented. Additionally, the goals of this diversity supplement are consistent with the Center’s aims to identify, mentor, and develop investigators from underrepresented racial and ethnic groups. This proposal will support the research and career development of Dr. Parente, providing skills and mentorship needed for her to build a career as an independent investigator.