513 - COVID Redeployment Unmasked Additional Gaps in Pediatric Palliative Care Curriculum

Poster Number: 513
Publication Number: 513.140

Alyssa Churchill, Cohen Children's Medical Center, Hewlett, NY, United States; Kristina Bianco, Cohen Children's Medical Center, New Hyde Park, NY, United States; Errica Capossela, Cohen Children's Medical Center, Astoria, NY, United States; Timothy Brandt, Cohen Children's Medical Center, New Hyde Park, NY, United States; Seema Amin, Cohen Children's Medical Center, Rego Park, NY, United States; Stephen R. Barone, Cohen Children's Medical Center, New Hyde Park, NY, United States

Background: Pediatric Palliative Care (PPC) is a relatively new field formally established in the early 2000s. Pediatric training programs have subsequently incorporated palliative care curricula to a variable degree. At the peak of the COVID pandemic, pediatric residents were called upon to care for adult patients in a large health system in NY. Debriefings uncovered the residents’ lack of experience and comfort in goals of care and end-of-life discussions. Residents requested enhanced training in palliative care topics.

Objective: To develop a longitudinal PPC curriculum with didactics and simulated encounters for pediatric residents to improve knowledge and comfort in PPC.

Design/Methods: The pediatric residents completed a needs-assessment with a validated survey, the Pediatric Palliative Care Questionnaire (PPCQ) (Brock 2015), to evaluate their comfort and knowledge of PPC. Based on the responses, a curriculum with 6 main themes was developed: (1) an introduction to palliative care, (2) delivering bad news, (3) discussing goals of care, (4) end of life care: symptoms and stages, (5) cultural and religious differences at the end of life, and (6) bereavement. Each 45-minute session includes a didactic and case-based simulation. Self-assessment surveys are completed after each session and the PPCQ will be repeated at the completion of the curriculum.

Results: Fifty-three of 101 residents completed the needs-assessment. The PPCQ uses a 5-point Likert scale. In regard to end-of-life discussions, 49% of residents were somewhat or very uncomfortable in participating in end-of-life discussions while 82% were somewhat or very uncomfortable in leading them. When queried whether they had received adequate training to lead palliative discussions, 81% strongly or somewhat disagreed. Similarly, 68% of residents strongly or somewhat disagreed that they received adequate training regarding palliative care pain management. Most residents (67%) participated in only 1-5 palliative care discussions during residency and 94% did not lead any discussions. Ninety-eight percent were interested in learning more about palliative care topics. Residents answered an average of 74% of the knowledge questions correctly prior to the curriculum.Conclusion(s): The COVID pandemic revealed a need for increased education in PPC for pediatric residents. A longitudinal curriculum of didactics and case-based simulations is a feasible way to improve resident knowledge and comfort in PPC. Further research is needed to evaluate how residents will incorporate these new skills into practice.