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Am J Hosp Palliat Care. 2018 Nov;35(11):1439-1445. doi: 10.1177/1049909118786870. Epub 2018 Jul 15.

Development and Implementation of an End-of-Life Curriculum for Pediatric Residents.

Author information

1
1 Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
2
2 Division of Hospital Medicine, Department of Pediatrics and General Internal Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, Cincinnati, OH, USA.
3
3 Division of Pediatric Emergency Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Abstract

BACKGROUND:

Caring for a child near the end of life (EOL) can be a stressful experience. Resident physicians are often the frontline providers responsible for managing symptoms, communicating difficult information, and pronouncing death, yet they often receive minimal education on EOL care.

OBJECTIVE:

To develop and implement an EOL curriculum and to study its impact on resident comfort and attitudes surrounding EOL care.

DESIGN:

Kern's 6-step approach to curriculum development was used as a framework for curriculum design and implementation.

SETTING/PARTICIPANTS:

Categorical and combined pediatric residents at a large quaternary care children's hospital were exposed to the curriculum.

MEASUREMENTS:

A cross-sectional survey was distributed pre- and postimplementation of the curriculum to evaluate its impact on resident comfort and attitudes surrounding EOL care.

RESULTS:

One-hundred twenty-six (49%) of 258 residents completed the preimplementation survey, and 65 (32%) of 201 residents completed the postimplementation survey. Over 80% of residents reported caring for a dying patient, yet less than half the residents reported receiving prior education on EOL care. Following curriculum implementation, the percentage of residents dissatisfied with their EOL education fell from 36% to 14%, while the percentage of residents satisfied with their education increased from 14% to 29%. The postimplementation survey identified that resident comfort with communication-based topics improved, and they sought additional training in symptom management.

CONCLUSIONS:

The implementation of a longitudinal targeted multimodal EOL curriculum improved resident satisfaction with EOL education and highlighted the need for additional EOL education.

KEYWORDS:

end-of-life care; end-of-life education; pallitaive care education; pediatric palliative care; pediatric resident; resident education

PMID:
30009618
DOI:
10.1177/1049909118786870

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