National Survey of Pediatric Residency Program Directors and Residents Regarding Education in Palliative Medicine and End-of-Life Care

Baker, Justin N.; Torkildson, Christy; Baillargeon, Jacques; Olney, Cynthia A.; Kane, Javier R.

doi:10.1089/jpm.2006.0135

Cited by 85 publications

(73 citation statements)

References 18 publications

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“…Compared to other studies, these results are likely an accurate reflection of the comfort level of fellows and the palliative care education that has been provided-in terms of hours and type of education, and the number of patients who die who are cared for by pediatric residents and fellows. 4,[6][7][8][9][10] There are several limitations to this study. Selection bias could play a part in fellows that completed the survey, and hence we would exercise caution when citing these results to make generalizations about the state of palliative care education in pediatric residencies and fellowships.…”

Section: Discussionmentioning

confidence: 98%

Reliability and Validity of the Pediatric Palliative Care Questionnaire for Measuring Self-Efficacy, Knowledge, and Adequacy of Prior Medical Education among Pediatric Fellows

Brock

Cohen

Popat

et al. 2015

Journal of Palliative Medicine

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Background: Interventions to improve pediatric trainee education in palliative care have been limited by a lack of reliable and valid tools for measuring effectiveness. Objective: We developed a questionnaire to measure pediatric fellows' self-efficacy (comfort), knowledge, and perceived adequacy of prior medical education. We measured the questionnaire's reliability and validity. Methods: The questionnaire contains questions regarding self-efficacy (23), knowledge (10), fellow's perceived adequacy of prior medical education (6), and demographics. The survey was developed with palliative care experts, and sent to fellows in U.S. pediatric cardiology, critical care, hematology/ oncology, and neonatalperinatal medicine programs. Measures of reliability, internal consistency, and validity were calculated. Results: One hundred forty-seven fellows completed the survey at test and retest. The self-efficacy and medical education questionnaires showed high internal consistency of 0.95 and 0.84. The test-retest reliability for the Self-Efficacy Summary Score, measured by intraclass correlation coefficient (ICC) and weighted kappa, was 0.78 (item range 0.44-0.81) and 0.61 (item range 0.36-0.70), respectively. For the Adequacy of Medical Education Summary Score, ICC was 0.85 (item range 0.6-0.78) and weighted kappa was 0.63 (item range 0.47-0.62). Validity coefficients for these two questionnaires were 0.88 and 0.92. Fellows answered a mean of 8.8/10 knowledge questions correctly; percentage agreement ranged from 65% to 99%. Conclusions: This questionnaire is capable of assessing self-efficacy and fellow-perceived adequacy of their prior palliative care training. We recommend use of this tool for fellowship programs seeking to evaluate fellow education in palliative care, or for research studies assessing the effectiveness of a palliative care educational intervention.

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Section: Discussionmentioning

confidence: 98%

Reliability and Validity of the Pediatric Palliative Care Questionnaire for Measuring Self-Efficacy, Knowledge, and Adequacy of Prior Medical Education among Pediatric Fellows

Brock

Cohen

Popat

et al. 2015

Journal of Palliative Medicine

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“…25 In spite of the need for more EOL education, postgraduate medical instruction for residents caring for terminally ill patients has traditionally remained very low. 12,[26][27][28][29] The lack of teaching about palliative care is ironic since it is during residency that most pediatricians must first assume primary responsibility for terminally ill patients. In fact, studies report discordance between the large number of dying children cared for during pediatric residency training and the scant emphasis placed on EOL education.…”

Section: Discussionmentioning

confidence: 99%

“…3,5,[8][9][10][11] A recent national survey of pediatric residency program directors revealed that less than one third have no faculty available to teach palliative care, and less than 40% of survey participants believed that matriculating residents are competent in palliative medicine. 12 During the academic year 2000-2001, pediatric house staff in the Pediatric Residency Training Program at the Stanford University School of Medicine cared for more than 120 children and adolescents who died (an average of 2 patients per resident). Similar to other training programs across the country, no formal palliative care curriculum existed in our program at the time.…”

mentioning

confidence: 99%

Introduction of a Pediatric Palliative Care Curriculum for Pediatric Residents

Schiffman

Chamberlain

Palmer

et al. 2008

Journal of Palliative Medicine

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“…[1][2][3] Despite recognizing the need to incorporate EOL education and palliative care into residency, 4-6 most pediatrics programs do not have a formal curriculum in EOL, especially in institutions where a pediatric palliative care service is not available.…”

Section: Introductionmentioning

confidence: 99%

A Curriculum to Improve Residents' End-of-Life Communication and Pain Management Skills During Pediatrics Intensive Care Rotation: Pilot Study

Asuncion¹,

Cagande²,

Schlagle³

et al. 2013

Journal of Graduate Medical Education

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Background Research suggests pediatrics practitioners lack confidence and skills in the end-of-life (EOL) care. Objective This pilot study explored the impact of a curriculum designed to prepare future pediatricians to manage pain and provide comfort for children and infants with life-threatening conditions and to be more confident and competent in their EOL discussions with families. Methods Participants included 8 postgraduate year (PGY)-2 residents in the study group and 9 PGY-3 residents in a control group. The EOL curriculum included 4, 1-hour sessions consisting of didactic lectures, videos, and small-group, interactive discussions. Topics included discussing EOL with families, withdrawal of care, and pain assessment and management. Curriculum evaluation used an objective structured clinical examination (OSCE), self-assessment confidence and competency questionnaire, and a follow-up survey 18 months after the intervention. Results The OSCE showed no statistically significant differences between PGY-2 versus PGY-3 residents in discussing EOL issues with family (mean = 48.3 [PGY-2] versus 41.0 [PGY-3]), managing withdrawal of care (mean = 20.9 [PGY-2] versus 18.91 [PGY-3]), and managing adolescent pain (mean = 30.97 [PGY-2] versus 29.27 [PGY-3]). The self-assessment confidence and competency scores improved significantly after the intervention for both PGY-2 residents (0.62 versus 0.86, P < .01) and PGY-3 residents (0.61 versus 0.85, P < .01). Conclusions An EOL curriculum for PGY-2 pediatrics residents delivered during the intensive care unit rotation is feasible and may be effective. Residents reported the curriculum was useful in their practice.

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National Survey of Pediatric Residency Program Directors and Residents Regarding Education in Palliative Medicine and End-of-Life Care

Cited by 85 publications

References 18 publications

Reliability and Validity of the Pediatric Palliative Care Questionnaire for Measuring Self-Efficacy, Knowledge, and Adequacy of Prior Medical Education among Pediatric Fellows

Reliability and Validity of the Pediatric Palliative Care Questionnaire for Measuring Self-Efficacy, Knowledge, and Adequacy of Prior Medical Education among Pediatric Fellows

Introduction of a Pediatric Palliative Care Curriculum for Pediatric Residents

A Curriculum to Improve Residents' End-of-Life Communication and Pain Management Skills During Pediatrics Intensive Care Rotation: Pilot Study

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