A Child's Last Hours'Multidisciplinary Training in End-of-Life Care in Children's Hospitals: School-Aged Child With Terminal Cancer

Marks, Adam; Hollenkamp, Elizabeth; Bradman, Sandra; Saul, D'Anna; Lehmann, Katie; Azim, James; Murphy, Terry; Giacomazza, Maureen; Trudeau, Cecilia; Pituch, Ken; Keefer, Patricia

doi:10.15766/mep_2374-8265.10371

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…This viewpoint has been echoed in other IPE resources utilizing interactive, team-based approaches. 16–17 Despite this, session organizers had some difficulty identifying additional learners to attend from the non-MD health professions, often due to differing academic calendars and schedules—a challenge cited in other literature. 7 This was particularly true of the second site.…”

Section: Discussionmentioning

confidence: 99%

Discharge Day: A Case-Based Interprofessional Exercise About Team Collaboration in Pediatrics

et al. 2019

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Introduction: Interprofessional education, which gives medical students the opportunity to learn from, with, and about other health professionals, is an essential component of the undergraduate medical education curriculum. Nonetheless, deliberate and sustained integration of interprofessional education into the undergraduate medical learning experience can be challenging, especially within the clinical setting. Methods: We implemented a 75-minute, interactive, collaborative, case-based conference focusing on an interprofessional clinical challenge in a pediatric setting. Medical students on their pediatrics core rotation and trainees within social work, nursing, pharmacy, and nutrition explored the concept of a team, reflected on roles, and considered how interprofessional collaboration could influence patient outcomes. Results: One hundred ninety-two health professions students participated in 15 sessions at three sites over a 10-month period (September 2017-July 2018). After each session, participants completed a session evaluation. They gave high ratings to the effectiveness and relevance of the experience and the case vignette. Responses to open-ended questions revealed that students had learned the importance of leveraging the expertise of team members and had resolved to speak up when faced with an interprofessional challenge in the future. Discussion: This case-based session is a logistically feasible and positively received opportunity for health professions students to discuss interprofessional collaboration. It could be adapted for a variety of learner populations and academic environments and could be incorporated into existing curricula.

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Section: Discussionmentioning

confidence: 99%

Discharge Day: A Case-Based Interprofessional Exercise About Team Collaboration in Pediatrics

et al. 2019

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“…The literature provides insights into various approaches to teaching palliative care to medical trainees, including simulation, roleplay, didactics, small-group work, and reflection. [5][6][7][13][14][15][16][17] The literature regarding the potential benefits of narrative medicine in palliative care education is limited 11 ; poetry has been used in palliative care and may have further potential in education, 18 and was added as a supplemental component into our curriculum. In our single-program educational initiative, we incorporated the various teaching modalities together in a longitudinal curriculum, and found that the multi-modal approach was rated as effective by pediatric residents.…”

Section: Discussionmentioning

confidence: 99%

“…Various teaching modules have been created and published using didactics, cases, videos, as well as standardized patients for multidisciplinary groups of learners who care for pediatric patients. [5][6][7][8] Confidence in caring for pediatric patients at end-of-life increased with these interventions. Narrative interventions, including reflective discussions of poetry, are being evaluated as medical education tools.…”

Section: Introductionmentioning

confidence: 99%

Implementation of a Multi-Modal Palliative Care Curriculum for Pediatric Residents

Romanos‐Sirakis

Demissie

Fornari

2021

Am J Hosp Palliat Care

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Objectives: To evaluate the feasibility and efficacy of a new multi-modal pediatric palliative care curriculum. We sought to determine the effect on comfort in palliative care, knowledge, and change in behavior by utilizing these skills with patients, and determine which modalities were most effective for residents. Study Design: 25 pediatric residents were exposed to the 4-part curriculum. The modalities utilized in this curriculum included didactics, role-play, videos, case-discussion, small group activities, simulation, poetry and reflection. Results: The pediatric residents self-reported an increase in comfort and knowledge of the components of pediatric palliative care after this curriculum. In addition, 74% of residents were able to identify a patient experience in which a component of the palliative care curriculum was utilized directly in patient care. The effectiveness of techniques utilized in this multimodal curriculum varied; residents reported that the poetry and reflection components were less effective, as compared with the role-play, simulation and other active learning components. Conclusions: Implementation of a multi-modal palliative care curriculum was effective in increasing knowledge in palliative care, comfort in breaking bad news, and caring for patients with palliative care needs. This can be translated into a change in behavior to utilize these new skills in the care of various patients in pediatrics. Among the various techniques used to teach this curriculum, residents reported that the techniques that most incorporated active learning and were directly applicable to the professional role of the resident were rated most valuable. This curriculum was well received, feasible and effective for pediatric residents.

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“…We were unable to identify any pediatric curricula specifically on withholding or withdrawing medically provided nutrition and hydration; however, prior published curricula have included this topic within broader discussions of end-of-life care. 16,17 Curricula focused on ethical challenges in the NICU have utilized standardized patient encounters, an approach that was not feasible to implement within our general residency curriculum. 18,19 The AAP Section on Bioethics offers a curriculum that includes a session entitled Brain Death, Permanent Vegetative State, and Medical Futility.…”

Section: Introductionmentioning

confidence: 99%

Ethical Dilemmas at the Beginning and End of Life: A Needs-Based, Experience-Informed, Small-Group, Case-Based Curriculum for Pediatric Residents

Herbst

deSante-Bertkau

2020

MedEdPORTAL

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Introduction: Pediatric residents are faced with ethical dilemmas in beginning-and end-of-life situations throughout their training. These situations are innately challenging, yet despite recommendations that residents receive training in ethics and end-of-life domains, they continue to report the need for additional training. To address these concerns, we developed an interactive and reflective palliative care and medical ethics curriculum including sessions focusing on ethical dilemmas at the beginning and end of life. Methods: This module includes a trio of case-based, small-group discussions on artificial nutrition and hydration, futility, and ethical considerations in neonatology. Content was developed based on a needs assessment, input from local experts, and previously published material. Trainees completed assessments of comfort and understanding before and after each session. Results: The module was attended and assessed by an average of 27 trainees per session, including residents and medical students. Knowledge of ethical considerations improved after individual sessions, with 86% of trainees reporting understanding ethical considerations involved in the decision to withdraw or withhold medically provided nutrition and hydration and 67% of trainees reporting understanding the use of the term futility. Trainee comfort in providing counseling or recommendations regarding specific ethical issues demonstrated a trend toward improvement but did not reach statistical significance. Discussion: We successfully implemented this innovative module, which increased trainees' comfort with end-of-life care and ethical conflicts. Future studies should focus on the trainees' ability to implement these skills in clinical practice.

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A Child's Last Hours'Multidisciplinary Training in End-of-Life Care in Children's Hospitals: School-Aged Child With Terminal Cancer

Cited by 6 publications

References 5 publications

Discharge Day: A Case-Based Interprofessional Exercise About Team Collaboration in Pediatrics

Discharge Day: A Case-Based Interprofessional Exercise About Team Collaboration in Pediatrics

Implementation of a Multi-Modal Palliative Care Curriculum for Pediatric Residents

Ethical Dilemmas at the Beginning and End of Life: A Needs-Based, Experience-Informed, Small-Group, Case-Based Curriculum for Pediatric Residents

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