Do You Really Know What Palliative Care Is? Developing an Electronic Palliative Care Information Card (S784)

Abstract

•Discuss results of comfort level of medical learners with palliative care.•Describe the EIC card that was formulated from results. Although palliative care (PC) is now prevalent in most hospital systems, many clinicians remain uncomfortable practicing primary-PC (PPC). Educational pocket tools have been shown to be low-cost and effective. Describe the process of developing a PC electronic information card (EIC) for medical learners assessing their PC knowledge needs and comfort level. Internal Medicine (IM) and Family Medicine (FM) residents were asked to complete survey assessing how comfortable they were on multiple PPC topics. Data was utilized to develop EIC. N=61, 51%=male. Age: 62% were 20-29 years-old. 70% IM, 30% FM. 52%=PGY-1, 25%=PGY-2, and 18%=PGY-3. 69%=never had a PC rotation. There were statistically significant differences in progression of level-of-comfort amongst interns through third year residents when dealing with PPC [code status (p<0.0113), delivering bad news (p<0.0018), leading family meeting (p<0.0013)]. Level-of-comfort increased with increasing residency year. However, there were statistically significant differences between topics residents felt comfortable with, and the tools that were requested. Although the majority of individuals reported comfort with goal-of-care (p<0.0001), advanced care planning (p<0.0206), family meetings (p<0.0112), and end-of-life expectations (p<0.0201), they still requested tools for these topics on the ECC. There were also statistically significant differences in those who felt uncomfortable with end-of-life care with the majority not requesting tools on this topic [managing mood disorders (p<0.0201) and nutrition and hydration (p<0.0398)]. Our PC residency curriculum seems appropriate, as evidenced by increasing comfort level as residents’ progress. However, there appears to be discrepancy regarding what resources residents need, and what resources they requested. Residents did not relate what they felt most comfortable with to what tools were chosen. Thus, they may have chosen topics that interested them, hence their increased comfort level, as opposed to topics where there was room for improvement and lower comfort levels.