437 - Introducing the Essential Power of Palliative Medicine through a Curriculum for Pediatric Residents

Publication Number: 437.5233

Alexandra C. Collell, University of Colorado School of Medicine, DENVER, CO, United States; Shweta Bhatia, University of Colorado School of Medicine, Denver, CO, United States; Adam B. Hill, Children, Aurora, CO, United States; Barry Seltz, University of Colorado School of Medicine, Aurora, CO, United States; Lauren Treat, University of Colorado School of Medicine, Aurora, CO, United States

Background: Pediatric palliative medicine focuses on improving the quality of life in patients with life-limiting and life-threatening diseases by using evidence-based communication skills to elicit value-based goals of care while assisting in decision-making and management. The AAP recommends that all clinicians have skills in providing basic palliative care. The ACGME states that residents should be able to advocate for patients to achieve end-of-life goals of care. However, standardized curricula are lacking.

Objective: We aimed to evaluate a new palliative medicine curriculum for pediatric residents after a local needs assessment identified an educational gap.

Design/Methods: A pediatric resident curriculum introducing palliative concepts was developed through collaboration among the institution’s palliative medicine team, two residents, and residency program leadership. Informed by self-determination theory, the curriculum consisted of a large group lecture introducing palliative medicine concepts, two small group sessions covering case-based practical applications of communication frameworks, and a “Go Wish” exercise to demonstrate the challenges of delineating one’s values. The curriculum was piloted at our program’s 3-hour education conference for senior residents in November 2023. A pre-post survey consisting of a 5-point Likert scale (1 = very uncomfortable, 5 = very comfortable) assessed understanding of palliative medicine concepts and elicited feedback through open-ended questions. The responses were analyzed using a t-test.

Results: 39 of 66 senior pediatric residents were scheduled for our pilot curriculum; 82% completed the pre-post survey. There was a significant increase in comfort with introducing palliative medicine concepts to patients, explaining distinctions between palliative medicine and hospice, describing common illness trajectories, and introducing palliative medicine at different illness stages (p-value for all < 0.001). Residents documented increased comfort participating in serious illness discussions (pre-mean = 3.13, post-mean = 3.69; p-value < 0.05) but did not demonstrate increased comfort in leading such discussions (pre-mean = 2.47, post-mean = 2.97; p-value = 0.11).

Conclusion(s): A palliative medicine curriculum promotes pediatric resident learning of primary palliative skills. We plan to transition this learning activity to intern residents and develop additional curricula to enhance senior resident palliative care skill acquisition. Further work is needed to assess the impact of this curriculum in the clinical setting.