WIP 52 - Improving ethics education for pediatric residents and fellows: A mixed methods study

Publication Number: WIP 52.7423

Rachel Dokko, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, United States; Danielle LoRe, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, United States; Kathleen Brennan, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Kelly M. Werner, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States

Background: Ethical reasoning is especially important in pediatrics where practitioners face unique ethical dilemmas in clinical practice which can lead to moral distress and burnout. In previous studies, pediatricians and pediatric trainees report inadequate ethics education and desire more ethics training. Given the demands of training, there is a need to further investigate house-staff ethical concerns, as well as to understand the elements of an ethics curriculum that would be of most interest and benefit to trainees.

Objective: We aim to survey pediatric residents and fellows to evaluate their moral and emotional distress, assess knowledge of pediatric ethical principles, assess comfort navigating ethical dilemmas, and ascertain the elements of an ethics education that would be of most benefit. We also aim to interview pediatric residents and fellows to derive themes about causes and consequences of ethical concerns and help further identify gaps in our ethics education.

Design/Methods: This IRB approved, mixed methods study was conducted at an urban quaternary-care academic children’s hospital. We included pediatric residents and fellows in critical care, neonatology, hematology and oncology, cardiology, and emergency medicine as higher levels of acuity have been shown to present unique ethical challenges and increase moral distress.

From August-October 2024, we conducted 15 semi-structured interviews which included open-ended questions about ethical concerns, moral distress, comfort navigating ethical scenarios, and desired ethics training. Interviews will be coded independently for thematic analysis by three investigators. We developed a Qualtrics survey which was reviewed for content and face validity with residents and fellows and our institution’s pediatric ethics committee. Our survey contains previously validated tools pertaining to moral distress and knowledge of pediatric ethical principles. We plan to recruit 60 residents and fellows to complete the survey from October-December 2024 and use descriptive statistics for data analysis.