Simulation training in Neuropalliative Care (P8-6.002)

Abstract

<h3>Objective:</h3> The purpose of our study is to evaluate if a simulation in neuropalliative care is a useful training method for neurology residents. <h3>Background:</h3> Education in palliative care is lacking in neurology training. The majority of neurology residency programs do not have a formal way to train and assess residents in this domain. <h3>Design/Methods:</h3> The simulation targeted adult and pediatric Neurology residents ranging from PGY2-PGY4. The Serious Illness Conversation Guide (SICG) was used as a framework. Residents first received a didactic reviewing the SICG, followed by two simulations with standardized patients (SPs). The first simulation focused on giving bad news in the outpatient setting. The second focused on shared decision making in the inpatient setting. Residents filled out surveys assessing their comfort levels before and after the simulations, as well as 3 months later to determine how it influenced their practice. <h3>Results:</h3> Twenty-one residents participated in the simulation. Survey responses were received from 100% of participants. After the simulation, respondents who felt comfortable giving bad news increased by 11% for the inpatient setting and by 19% for the outpatient setting. There was a trend towards improved comfort in assessing illness understanding, managing uncertainty in prognosis, making a recommendation based on patient goals, and discussing hospice options. Overall, 91% thought the simulation accurately represented real life and 100% felt that the simulation would influence their future practice. At 3 months after the simulation, 85% of trainees reported using the SICG in palliative care conversations. <h3>Conclusions:</h3> Simulation training with SPs is a valuable way to train neurology residents in neuropalliative care discussions. Future simulations can tailor specific scenarios to resident level of training. <b>Disclosure:</b> Dr. Lalla has nothing to disclose. Ms. Dobie has nothing to disclose. The institution of Dr. Bissonnette has received research support from Michael J Fox Foundation. The institution of Dr. Bissonnette has received research support from Cogan Family Foundation. Dr. Lau has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint. The institution of Dr. Lau has received research support from Amyloidosis Foundation. Dr. Tulsky has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for American Board of Internal Medicine. Dr. Kaku has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Fatcliffe Harten Galamaga LLP.