Training Pediatric Fellows In Palliative Care: A Pilot Comparison Of Simulation Training And Didactic Education

Title

Training Pediatric Fellows In Palliative Care: A Pilot Comparison Of Simulation Training And Didactic Education

Creator

Brock Katharine E; Cohen Harvey J; Sourkes Barbara M; Good Julie J; Halamek Louis P

Identifier

10.1089/jpm.2016.0556

Publisher

Journal Of Palliative Medicine

Date

2017

Subject

Communication; End-of-life; Medical Education; Palliative Care; Pediatric Fellows; Pediatrics; Simulation

Description

BACKGROUND: Pediatric fellows receive little palliative care (PC) education and have few opportunities to practice communication skills. OBJECTIVE: In this pilot study, we assessed (1) the relative effectiveness of simulation-based versus didactic education, (2) communication skill retention, and (3) effect on PC consultation rates. DESIGN: Thirty-five pediatric fellows in cardiology, critical care, hematology/oncology, and neonatology at two institutions enrolled: 17 in the intervention (simulation-based) group (single institution) and 18 in the control (didactic education) group (second institution). Intervention group participants participated in a two-day program over three months (three simulations and videotaped PC panel). Control group participants received written education designed to be similar in content and time. MEASUREMENTS: (1) Self-assessment questionnaires were completed at baseline, post-intervention and three months; mean between-group differences for each outcome measure were assessed. (2) External reviewers rated simulation-group encounters on nine communication domains. Within-group changes over time were assessed. (3) The simulation-based site's PC consultations were compared in the six months pre- and post-intervention. RESULTS: Compared to the control group, participants in the intervention group improved in self-efficacy (p = 0.003) and perceived adequacy of medical education (p < 0.001), but not knowledge (p = 0.20). Reviewers noted nonsustained 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). CONCLUSIONS: This simulation-based curriculum is an effective method for improving PC comfort, education, and consults. More frequent practice is likely needed to lead to sustained improvements in communication competence.

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

June 2017 List

URL Address

http://www.ncbi.nlm.nih.gov/pubmed/28436742

Citation

Brock Katharine E; Cohen Harvey J; Sourkes Barbara M; Good Julie J; Halamek Louis P, “Training Pediatric Fellows In Palliative Care: A Pilot Comparison Of Simulation Training And Didactic Education,” Pediatric Palliative Care Library, accessed March 29, 2024, https://pedpalascnetlibrary.omeka.net/items/show/10908.