Food, toys, and love: pediatric palliative care
PedPal Lit; Adolescent Adult Child Child; Non-U.S. Gov't United States; Preschool Cultural DiversityFood Humans Infant Interdisciplinary CommunicationLove Needs Assessment Palliative Care/organization & administrationPediatricsPlay and Playthings Research Support
2005
Sourkes B; Frankel L; Brown M; Contro N; Benitz W; Case C; Good J; Jones L; Komejan J; Modderman-Marshall J; Reichard W; Sentivany-Collins S; Sunde C
Current Problems in Pediatric and Adolescent Health Care
2005
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/j.cppeds.2005.09.002" target="_blank" rel="noreferrer">10.1016/j.cppeds.2005.09.002</a>
Improving Training In Palliative Care For Pediatric Fellows -- A Simulation-based Multi-institution Trial.
Objectives
Describe different methods of palliative care education,
including simulation-based education and
didactic education.
Delineate differences between pediatric fellow
self-assessment data and external reviewer data
of fellow performance.
Describe how a simulation-based curriculum can
lead to changes in palliative care consultation at
an institution.
Original Research Background. Although palliative
care (PC) skills can be learned ‘‘on the job,’’ pediatric
trainees have few opportunities and often receive no
formal PC education.
Research Objectives. (1) To assess whether simulation-based
or didactic education is a more effective
method for teaching PC communication. (2) To assess
competence over time. (3) To determine if PC consultation
rates would increase after simulation-based
education.
Methods. (1) 35 pediatric fellows from cardiology, critical
care, oncology and neonatology at two institutions
enrolled 17 in the intervention group (IG) and 18 in
the control group (CG). IG fellows participated in a 2-
day intervention over three months consisting of three
simulation scenarios with debriefing and a videotaped
PC lecture. CG fellows received written PC education
designed to be similar in content and time. Assessments
were measured at baseline, post-intervention and at
three months; mean differences for each outcome measure
were assessed. (2) External reviewers rated IG encounters
on nine communication competencies.
Changes over time were assessed. (3) PC consultations
from the IG institution’s four departments were
compared in the six months pre- and post-intervention,
normalized to inpatient admissions and hospital days.
Results. Over three months, IG fellows significantly
improved in self-efficacy (p¼0.003) and perceived adequacy
of medical education (p<0.001), but not
knowledge (p¼0.20) when compared to CG fellows.
External reviewers noted improvement in three
competencies (relationship building (p¼0.04), opening
discussion (p¼0.01), gathering information
(p¼0.01)). There was a 65% increase in PC consultation
rate, but no difference when normalized to inpatient
admissions or hospital days (OR 1.5, 95% CI
0.9-2.5 for both). IG fellows more strongly agreed
that they would use (p¼0.04) and recommended
(p¼0.004).the education.
Vol. 51 No. 2 February 2016 Schedule with Abstracts 323
Conclusion. Our simulation-based curriculum is an
effective method for teaching PC communication to
pediatric fellows compared with a didactic education
model.
Brock K; Cohen H; Sourkes B; Good J; Halamek L
Journal Of Pain And Symptom Management
2016
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
DOI: http://dx.doi.org/10.1016/j.jpainsymman.2015.12.141
Training Pediatric Fellows In Palliative Care: A Comparison Of Simulation-based Training And Didactic Education
Curriculum; Palliative Therapy; Simulation; Cardiology; Child; Clinical Trial; Comfort; Communication Skill; Controlled Clinical Trial; Controlled Study; Family; Female; Hematology; Human; Human Versus Animal Comparison; Male; Medical Education; Neonatology; Nonhuman; Oncology; Physician; Pilot Study; Resuscitation; Single Blind Procedure
Background: Although palliative care (PC) communication skills can be learned through trial and error, pediatric fellows have few opportunities to practice communication, and learning by doing may be harmful for families. Despite these issues and recommendations from professional societies, most fellowship programs either lack formal training or provide only lecture-based PC education. Simulation-based training has been successful in other high-stakes communication encounters, and has the potential to change PC education. Objectives: In this pilot study,we assessed: (1) the relative effectiveness of simulation-based vs didactic education, (2) communication skill retention, and (3) effect on PC consultation rates. Design/Method: Thirty-five pediatric fellows in hematology/oncology, cardiology, critical care, and neonatology at two institutions enrolled: 17 in the simulation-based group (single institution) and 18 in the didactic education group (second institution). Simulation-based subjects participated in a 2-day program over 3 months (three simulations and videotaped PC panel) where scenarios focused on: introducing PC, discussing goals of care and resuscitation preferences, and mediating disagreement between the family and medical team. Didactic-education subjects received written education designed to be similar in content and time. (1) Fellow selfassessments in PC comfort, knowledge, and adequacy of medical education, were measured at baseline, post-intervention and three months; mean between-group differences for each outcome measure were assessed. (2) Two blinded external reviewers rated each simulation-group fellow's encounters on nine communication domains. Within-group changes over time were assessed. (3) The simulation-based site's PC consultation rate was compared in the six months pre- and post-intervention. Results: Compared to the didactic group, subjects in the simulation-based group improved in PC comfort/ self-efficacy (16.4 vs 6.1, DELTA10.3, p = 0.003) and perceived adequacy of medical education (7.4 vs 0.4, DELTA7.1, p<0.001). Both groups had improved PC knowledge; this was not different between groups (1.1 vs 1.8, DELTA-0.7, p = 0.20). Reviewers noted non-sustained improvement in four domains: relationship building (p = 0.01), opening discussion (p = 0.03), gathering information (p = 0.01), and communicating accurate information (p = 0.04). PC consultation rate increased 64%, an improvement when normalized to average daily census (p = 0.04). Simulation-group fellows more strongly agreed that they would use the education in practice (p = 0.04), and recommended that educational methodology (p = 0.004). Conclusion: Well-trained physicians are necessary to providing high quality PC. This simulation-based curriculum is an effective method for improving PC comfort, education, and consults, although it does not lead to sustained improvements in communication competence or knowledge. More frequent, deliberate practice is likely needed to lead to sustained improvements in communication competence.
Brock K; Cohen H; Sourkes B; Good J; Halamek L
Pediatric Blood And Cancer
2017
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
10.1002/pbc.26591