Publication
Improving Pediatric Residency End-Of-Life Education: A Quality Improvement Approach
Spratt K, Cirotski D, Vallely J, Mehta A · Journal of Pain and Symptom Management · 2024
Outcomes: 1. Participants will be able to understand that a quality improvement model is an effective method for developing graduate medical education curricula for end-of-life care. 2. Participants will be able to recognize the lack of pediatric resident physician education in end-of-life care. Key Message: This quality improvement project aimed at improving pediatric resident physicians' comfort and competency in providing end-of-life care. A curriculum, including lectures on post-patient death tasks was created and implemented. Pre- and post-lecture surveys showed significant improvement in resident comfort levels, highlighting the effectiveness of lectures in teaching end-of-life care. Continued assessment after future topics and interventions will optimize education Background: Inspired by personal experiences of the resident physician authors, counseling a dying patient and their family as well as providing end-of-life (EOL) care can often be a clinically and emotionally challenging experience for providers. Resident physicians are frequently the frontline providers when a pediatric patient is receiving EOL care in the inpatient setting. However, pediatric resident physicians often report low comfortability with providing EOL services [1]. Objective(s): To create and implement an EOL curriculum for pediatric resident physicians to use in their training and future careers. Setting/Participants: Categorical pediatrics residents at a tertiary care children's hospital were exposed to the curriculum. Method(s): This study was a quality improvement project with multiple PDSA cycles. A lecture was designed and implemented by resident physicians and a pediatric palliative care specialist. The topics addressed included immediate actions following a patient's death and symptom management of actively dying patients. A cross-sectional survey was administered pre- and post-implementation to assess comfortability with providing end-of-life care and future directions for the curriculum. Result(s): Twenty-seven residents completed the pre-lecture survey, and 13 residents completed the post-lecture survey. Two sample t-testing revealed a significant difference in the responses to repeated competency question (P=4.81E-8). Quality resident responses identified perceived deficiencies, including symptom management, discussing death, the pathophysiology of death, and resident coping skills following the death of a patient. Conclusions/Future Direction: In the first cycle of this quality improvement project, residents participated in a lecture regarding the tasks to complete after a patient dies in the hospital. Resident comfort with this competency significantly improved following the lecture, suggesting that lectures can be an effective way to teach end-of-life care. These responses help to inform the next cycle of this project. Keywords: Quality ImprovementCopyright © 2024
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