Implementation of a Competency-Based, Interdisciplinary Pediatric Palliative Care Curriculum Using Content and Format Preferred by Pediatric Residents

Meaghann Weaver,Christopher Wichman

doi:10.3390/children5120156

Meaghann Weaver, Christopher Wichman

Open Access

https://doi.org/10.3390/children5120156

Copy DOI

Abstract

Palliative care competencies at the pediatric resident training level expand learned knowledge into behavior. The objective of this study was to investigate mode of palliative care education delivery preferred by pediatric residents and to report on participatory approach to resident palliative care curriculum design. A one-hour monthly palliative care curriculum was designed and implemented in a participatory manner with 20 pediatric residents at a free-standing Midwestern children’s hospital. Outcome measures included pediatric residents’ personal attitude and perceived training environment receptivity before and after implementation of a palliative care competency-based curriculum. An 18-item survey utilizing Social Cognitive Theory Constructs was administered at baseline and after palliative care curriculum implementation (2017–2018 curricular year). Pediatric residents prioritized real case discussions in group format (16/20) over other learning formats. Topics of highest interest at baseline were: discussing prognosis and delivering bad news (weighted average 12.9), pain control (12.3), goals of care to include code status (11.1), and integrative therapies (10.7). Summary of ordinal responses revealed improvement in self-assessment of personal attitude toward palliative care and training environment receptivity to palliative care domains after year-long curriculum implementation. Curricular approach which is attentive to pediatric residents’ preferred learning format and self-assessment of their behaviors within their care setting environment may be beneficial in competency-based primary palliative training.

Highlights

Curricular models have recently been developed for palliative care competencies in medical school and residency programs [1,2]
Each monthly Pal Care Power Hour in-person session consisted of: a real life palliative care actionable case example, topical palliative care content learning relevant to the case, and group discussion for application in local care setting
(11.1), and integrative therapies (10.7). This prioritization of curricular topics resulted in participatory development of the teaching content (Appendix A)

Summary

Introduction

Curricular models have recently been developed for palliative care competencies in medical school and residency programs [1,2]. A prior study exploring six hours of palliative care education revealed statistically significant improvement in pediatric resident learning and confidence after curricular implementation [4]. A competency-based palliative care education emphasizes a knowledge base, but an actual behavior and a perception of feasibility within the care setting environment so that knowledge becomes an action [5]. Competency-based curricula ideally reach bedside impact, as a mandatory core pain management palliative care curriculum for surgical residents was found to improve patient perception of pain control [6]. Behavioral theory has been under-utilized in curricular design.

Objectives

Methods

Results

Conclusion