Improving Training In Palliative Care For Pediatric Fellows -- A Simulation-based Multi-institution Trial.

Title

Improving Training In Palliative Care For Pediatric Fellows -- A Simulation-based Multi-institution Trial.

Creator

Brock K; Cohen H; Sourkes B; Good J; Halamek L

Identifier

DOI: http://dx.doi.org/10.1016/j.jpainsymman.2015.12.141

Publisher

Journal Of Pain And Symptom Management

Date

2016

Description

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.

Rights

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).

Citation List Month

March 2016 List

Citation

Brock K; Cohen H; Sourkes B; Good J; Halamek L, “Improving Training In Palliative Care For Pediatric Fellows -- A Simulation-based Multi-institution Trial.,” Pediatric Palliative Care Library, accessed November 29, 2021, https://pedpalascnetlibrary.omeka.net/items/show/10570.

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