1
40
7
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<a href="http://doi.org/10.1080/09699260.2021.1871578" target="_blank" rel="noreferrer noopener">http://doi.org/10.1080/09699260.2021.1871578</a>
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Impact of a pediatric palliative care team on resident education in end of life care
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Progress in Palliative Care
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2021
Subject
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hospice and palliative medicine; pediatric palliative care; resident education
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Pennarola B; MacDonell-Yilmaz RE; Sprinz P; Renaud T
Description
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Introduction: The presence of Pediatric Palliative Care (PPC) teams and PPC curricula at teaching hospitals are shown to increase resident physician education in pain and symptom management. However, their impact on residents' comfort in caring for children at the end of life (EOL) is not well studied. We sought to examine whether differences exist in reported levels of experience and education with palliative andEOL care among physicians completing residency before versus after the development of a PPC team. Method(s): We surveyed 329 pediatrics residents and graduates from our medium-sized children's hospital about their experiences and education in providing palliative or EOL care to pediatric patients. We compared responses from residents who completed training prior to the development of a PPC team to those who completed training after its implementation. Result(s): 149 individuals (45%) responded. Participants who completed residency during or after the implementation of the PPC team were more likely to agree that they received education about EOL symptom management (K<sup>2</sup> = 11.58, P < 0.001) and felt comfortable caring for patients at EOL (K <sup>2</sup> = 5.62, P = 0.02). Discussion(s): Our findings suggest a beneficial impact of PPC team presence on pediatrics resident education. When appropriate, involving of pediatrics residents in the care of children approaching EOL should be supported and encouraged. Copyright © 2021 Informa UK Limited, trading as Taylor & Francis Group.
Identifier
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<a href="http://doi.org/10.1080/09699260.2021.1871578" target="_blank" rel="noreferrer noopener">10.1080/09699260.2021.1871578</a>
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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).
2021
April 2021 List
hospice and palliative medicine
MacDonell-Yilmaz RE
Pediatric Palliative Care
Pennarola B
Progress In Palliative Care
Renaud T
resident education
Sprinz P
-
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March 2021 List
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March 2021 List
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<a href="http://doi.org/10.1177/1049909121990826" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/1049909121990826</a>
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Implementation of a Multi-Modal Palliative Care Curriculum for Pediatric Residents
Publisher
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American Journal of Hospice & Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Subject
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palliative care; resident education; medical education; curriculum
Creator
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Romanos-Sirakis E; Demissie S; Fornari A
Description
An account of the resource
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.
Identifier
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<a href="http://doi.org/10.1177/1049909121990826" target="_blank" rel="noreferrer noopener">10.1177/1049909121990826</a>
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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).
2021
American journal of hospice & palliative care
Curriculum
Demissie S
Fornari A
March 2021 List
Medical Education
Palliative Care
resident education
Romanos-Sirakis E
-
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Title
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May 2020 List
Text
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May 2020 List
URL Address
<a href="http://doi.org/10.1177/1049909120913041" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/1049909120913041</a>
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Title
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Pediatric Resident Perception and Participation in End-of-Life Care
Publisher
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American Journal of Hospice and Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2020
Subject
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communication; end-of-life care; medical education; palliative care; pediatrics; resident education
Creator
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Niehaus J Z; Palmer M; LaPradd M; Haskamp A; Hatton A; Scanlon C; Hill A B
Description
An account of the resource
BACKGROUND: Despite advances in medical care, pediatric deaths are still an unfortunate reality. Most of these deaths occur within a hospital setting. End-of-life care is an important part of medical care for children with serious illnesses. Despite the importance, pediatric providers report a lack of comfort surrounding end-of-life care. OBJECTIVE: To assess categorical pediatric residents' perceptions and participation in providing end-of-life care to dying children and their families. STUDY DESIGN: This is a survey-based, descriptive, mixed-methods study. Survey was sent to categorical pediatric residents at Indiana University School of Medicine in June 2018 to obtain both quantitative and qualitative information on resident perception and participation in end-of-life care. Surveys were sent to 100 residents with a response rate of 68%. SETTING/PARTICIPANTS: Pediatric residents at Indiana University School of Medicine. RESULTS: The comfort and participation in end-of-life care are limited in all levels of pediatric training. Residents do not feel comfortable with 19 of 22 questions related to end-of-life care. Only 32% of residents felt their education prepared them to participate in end-of-life care. Almost one-fifth (19.5%) of residents report participating in zero aspect of end-of-life care. Themes discussed by residents include education, experience, communication, social norms, emotions, self-care, comfort, and family. CONCLUSION: More formalized education and training is needed to increase resident comfort with and participation in end-of-life care. Such future interventions should focus on communication surrounding difficult conversations and providing guidance for families.
Identifier
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<a href="http://doi.org/10.1177/1049909120913041" target="_blank" rel="noreferrer noopener">10.1177/1049909120913041</a>
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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).
2020
American Journal Of Hospice And Palliative Care
Communication
End-of-life Care
Haskamp A
Hatton A
Hill A B
LaPradd M
May 2020 List
Medical Education
Niehaus J Z
Palliative Care
Palmer M
Pediatrics
resident education
Scanlon C
-
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Title
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October 2019 List
Text
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October 2019 List
URL Address
<a href="http://doi.org/10.1016/j.acap.2019.07.008" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.acap.2019.07.008</a>
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Pediatric Resident Experience Caring for Children at the End of Life in a Children's Hospital
Publisher
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Academic pediatrics.
Date
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2019
Subject
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death; article; child; female; human; major clinical study; male; palliative therapy; retrospective study; controlled study; terminal care; resuscitation; education; medical record review; statistics; burnout; drug withdrawal; Burnout; End-of-Life Care; life sustaining treatment; Palliative Care; postgraduate student; resident; Resident Education
Creator
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Trowbridge A; Bamat T; Griffis H; McConathey E; Feudtner C; Walter J K
Description
An account of the resource
OBJECTIVES: Pediatric residents are expected to be competent in end of life (EOL) care. We aimed to quantify pediatric resident exposure to patient deaths, and the context of these exposures. METHOD(S): Retrospective chart review of all deceased patients at one children's hospital over three years collected patient demographics, time and location of death. Mode of death was determined after chart review. Each death was cross-referenced with pediatric resident call schedules to determine residents involved within 48 hours of death. Descriptive statistics are presented. RESULT(S): Of 579 patients who died during the study period, 46% had resident involvement. Most deaths occurred in the NICU (30% of all deaths) however, resident exposure to EOL care most commonly occurred in the PICU (52% of resident exposures) and were after withdrawals of life-sustaining therapy (41%), followed by non-escalation (31%) and failed resuscitation (15%). During their post-graduate year (PGY)-1, <1% of residents encountered a patient death. During PGY-2 and PGY-3, 96% and 78%, respectively, of residents encountered at least one death. During PGY-2, residents encountered a mean of 3.5 patient deaths (range 0-12); during PGY-3, residents encountered a mean of 1.4 deaths (range 0-5). Residents observed for their full 3-year residency encountered a mean of 5.6 deaths (range 2-10). CONCLUSION(S): Pediatric residents have limited but variable exposure to EOL care, with most exposures in the ICU after withdrawal of life-sustaining technology. Educators should consider how to optimize EOL education with limited clinical exposure, and design resident support and education with these variable exposures in mind. Copyright © 2019. Published by Elsevier Inc.
Identifier
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<a href="http://doi.org/10.1016/j.acap.2019.07.008" target="_blank" rel="noreferrer noopener">10.1016/j.acap.2019.07.008</a>
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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).
2019
Academic pediatrics.
Article
Bamat T
Burnout
Child
Controlled Study
Death
Drug Withdrawal
Education
End-of-life Care
Female
Feudtner C
Griffis H
Human
Life Sustaining Treatment
Major Clinical Study
Male
McConathey E
Medical Record Review
October 2019 List
Palliative Care
Palliative Therapy
postgraduate student
Resident
resident education
Resuscitation
Retrospective Study
Statistics
Terminal Care
Trowbridge A
Walter J K
-
Dublin Core
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Title
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January 2019 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
January 2019 List
URL Address
<a href="http://doi.org/10.3390/children5120156" target="_blank" rel="noreferrer noopener"> http://doi.org/ 10.3390/children5120156</a>
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Title
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Implementation of a Competency-Based, Interdisciplinary Pediatric Palliative Care Curriculum Using Content and Format Preferred by Pediatric Residents
Publisher
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Children
Date
A point or period of time associated with an event in the lifecycle of the resource
2018
Subject
The topic of the resource
pediatric palliative care; resident education; social cognitive theory
Creator
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Weaver MS; Wichman C
Description
An account of the resource
Palliative care competencies at the pediatric resident training level expand learned knowledge into behavior. The objective of this study was to investigate mode of palliative care education delivery preferred by pediatric residents and to report on participatory approach to resident palliative care curriculum design. A one-hour monthly palliative care curriculum was designed and implemented in a participatory manner with 20 pediatric residents at a free-standing Midwestern children's hospital. Outcome measures included pediatric residents' personal attitude and perceived training environment receptivity before and after implementation of a palliative care competency-based curriculum. An 18-item survey utilizing Social Cognitive Theory Constructs was administered at baseline and after palliative care curriculum implementation (2017(-)2018 curricular year). Pediatric residents prioritized real case discussions in group format (16/20) over other learning formats. Topics of highest interest at baseline were: discussing prognosis and delivering bad news (weighted average 12.9), pain control (12.3), goals of care to include code status (11.1), and integrative therapies (10.7). Summary of ordinal responses revealed improvement in self-assessment of personal attitude toward palliative care and training environment receptivity to palliative care domains after year-long curriculum implementation. Curricular approach which is attentive to pediatric residents' preferred learning format and self-assessment of their behaviors within their care setting environment may be beneficial in competency-based primary palliative training.
Identifier
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<a href="http://doi.org/10.3390/children5120156" target="_blank" rel="noreferrer noopener">10.3390/children5120156</a>
2018
Children
January 2019 List
Pediatric Palliative Care
resident education
social cognitive theory
Weaver MS
Wichman C
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
October 2016 List
Dublin Core
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Title
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Pocket Reference Card Improves Pediatric Resident Comfort In Caring For Children At End Of Life
Publisher
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Journal Of Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2016
Subject
The topic of the resource
Quality; Barriers; Perspectives; Palliative Care; Providers; Pain Management; Medicine; National-survey; Education; Health Care Sciences & Services
Medical Education; Pediatric Palliative Care; Resident education
Creator
An entity primarily responsible for making the resource
Emily M Balkin; Katherine Ort; Robert Goldsby; Jessica Duvall; Cynthia D Kim
Description
An account of the resource
Background: Studies have shown that pediatricians in all stages of training are uncomfortable managing patients at end of life. Our goal was to create and test a portable reference card to improve pediatric resident education in comprehensive care for children nearing end of life.
Methods: We evaluated the impact of the Pediatric End-of-Life Care Management Reference Card on residents' perceived comfort and knowledge through pre- and post-intervention surveys. The preintervention questionnaires and pocket cards were distributed to all first- and second-year residents, and then a follow-up survey was provided six months later. Based on Likert scales, questions focused on self-reported understanding of palliative care principles and knowledge regarding and comfort in performing end-of-life symptom management.
Results: Twenty-six pediatric residents completed pre- and post-intervention surveys. Following receipt of the reference card, no significant changes were noted consistently across all groups of residents. The majority of improvements were noted when comparing second to third year residents, including knowledge and comfort related to pain management, comfort in managing secretions and nausea, and documentation following death. The first to second year residents demonstrated improvement in knowing what language to use to tell a family that their child has died.
Conclusion: This study demonstrates that a portable reference card may be a convenient, simple, and useful component of education for pediatric residents in end-of-life care management. This reference card is a foundation from which to develop a standardized educational tool. Additional research is required to assess the impact of this type of intervention in pediatric palliative care education.
Identifier
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doi:10.1089/jpm.2016.0247
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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).
2016
Barriers
Cynthia D Kim
Education
Emily M Balkin
Health Care Sciences & Services
Jessica Duvall
Journal of Palliative Medicine
Katherine Ort
Medical Education
Medicine
National-survey
October 2016 List
Pain Management
Palliative Care
Pediatric Palliative Care
Perspectives
Providers
Quality
resident education
Robert Goldsby
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
October 2016 List
Dublin Core
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Title
A name given to the resource
Pediatric Palliative Care Pilot Curriculum: Impact Of "pain Cards" On Resident Education
Publisher
An entity responsible for making the resource available
American Journal Of Hospice And Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2016
Subject
The topic of the resource
Adult; Communication; Curriculum; Female; Health Knowledge Attitudes Practice; Hospitals Pediatric/organization & Administration; Humans; Internship And Residency/methods; Male; Pain Management; Pain Measurement; Palliative Care; Pediatrics/education; Pilot Projects
Palliative Care Curriculum; Palliative Care Education; Pediatric Palliative Care; Pediatric resident; Pocket cards; Resident education
Creator
An entity primarily responsible for making the resource
Barnett MD; Maurer SH; Wood GJ
Description
An account of the resource
BACKGROUND:
Prior research has shown that less than 40% of pediatric program directors believe their graduating residents competent in palliative care. While many curricula have been developed to address this need, few have demonstrated improved comfort and/or knowledge with palliative care principles. The purpose of this study was to test a pocket card educational intervention regarding resident knowledge and comfort with palliative care principles.
METHODS:
Pocket reference cards were created to deliver fundamentals of pediatric palliative care to resident learners; didactics and case studies emphasized principles on the cards. Self-reported comfort and objective knowledge were measured before and after the curriculum among residents.
RESULTS:
Of 32 post-graduate year 2 (PGY2) residents, 23 (72%) completed the pre-test survey. The post-test was completed by 14 PGY2 residents (44%) and 16 of 39 PGY3/4 residents (41%). There was improvement in comfort with communication, as well as pain and symptom management among the residents. Knowledge of palliative care principles improved in part, with only a few survey questions reaching statistical significance. 100% of respondents recommended the cards be provided to their colleagues.
CONCLUSION:
This longitudinal curriculum, designed specifically for pediatric residents, was built into an existing training program and proved to be popular, feasible, and effective at improving comfort with basic palliative care principles.
Identifier
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DOI: 10.1177/1049909115590965
Rights
Information about rights held in and over the resource
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).
2016
Adult
American Journal of Hospice and Palliative Medicine
Barnett MD
Communication
Curriculum
Female
Health Knowledge Attitudes Practice
Hospitals Pediatric/organization & Administration
Humans
Internship And Residency/methods
Male
Maurer SH
October 2016 List
Pain Management
Pain Measurement
Palliative Care
Palliative Care Curriculum
Palliative Care Education
Pediatric Palliative Care
Pediatric resident
Pediatrics/education
Pilot Projects
Pocket cards
resident education
Wood GJ