Gaps in Palliative Care Education among Neonatology Fellowship Trainees


Gaps in Palliative Care Education among Neonatology Fellowship Trainees


Wraight CL; Eickhoff JC; McAdams RM


Palliative Medicine Reports




Nicu; residency; medical education; curriculum; training program


Background: To provide proper care for infants at risk for death, neonatologists need expertise in many areas of palliative care. Although neonatology training programs have implemented a wide variety of palliative care educational programs, the impact of these programs on trainees' skills and effective communication regarding end-of-life issues remains unclear. Objective: To determine whether neonatology fellowship programs are providing formal palliative care education and assess whether this education is effective at increasing fellows' self-reported comfort with these important skills. Methods: An anonymous survey was sent to program directors (PDs) and fellows of ACGME accredited neonatology fellowship programs in the United States. Using a 5-point Likert scale, participants were asked about the palliative care education they received, and their comfort level with several key aspects of palliative care. Results: Twenty-four (26%) PDs and 66 (33%) fellows completed the survey. Fourteen PDs (58%) reported including palliative care education in their formal fellowship curriculum, whereas only 20 (30%) responding fellows reported receiving palliative care education. Of the responding fellows, most (80%) reported being uncomfortable or only somewhat comfortable with all assessed areas of palliative care. Fellows who received formal education were more comfortable than those without it in leading goals of care conversations (p = 0.001), breaking bad news (p = 0.048), discussing change in code status (p = 0.029), and grief and bereavement (p = 0.031). Conclusions: Most fellows report being uncomfortable or only somewhat comfortable with essential areas of palliative care. Formal palliative care education improves fellows' self-reported comfort with important aspects of end-of-life care. To promote a well-rounded neonatology fellowship curriculum, inclusion of formal palliative care education is recommended.


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

February 2022 List



Wraight CL; Eickhoff JC; McAdams RM, “Gaps in Palliative Care Education among Neonatology Fellowship Trainees,” Pediatric Palliative Care Library, accessed June 24, 2024,