National survey of pediatric residency program directors and residents regarding education in palliative medicine and end-of-life care.
OBJECTIVE
To determine how palliative and end-of-life care can best be incorporated into the training of pediatric residents.


METHODS
From 2001 to 2002, we surveyed 246 directors and 235 residents of pediatric residency programs. We elicited responses regarding (1) perceived relevance of pediatric palliative care, (2) residents' exposure to palliative medicine, (3) competency of faculty and matriculating residents in palliative care, (4) core palliative medicine competencies, and (5) the best teaching/learning format for palliative care.


RESULTS
Fifty-five directors (22.4%) and 98 residents (42.0%) responded. More than three quarters of directors (78.1%) agreed with the statement that palliative care as a competency is "somewhat" to "very" important. Approximately one third (32.7%) agreed with the statement that their residents were not clinically exposed to end-of-life care; 99.0% of the residents indicated participation in such care. Almost one third of directors (27.3%) indicated that they had no faculty available to teach palliative care. Only 38.2% agreed with the statement that matriculating residents are competent in palliative medicine while many residents indicated having limited or no training in core palliative care competencies.


CONCLUSIONS
For palliative care principles to be better incorporated into pediatric practice, they must be incorporated into residency education, optimally through informal teaching and during rounds. Finding ways to teach residents palliative medicine during clinical "teachable moments" and standardizing didactic curricula should become a priority in palliative and end-of-life care education.
Baker
Justin N
JN
Department of Oncology, Palliative and End of Life Task Force, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
Torkildson
Christy
C
Baillargeon
Jacques G
JG
Olney
Cynthia A
CA
Kane
Javier R
JR
D032722:Advance Care Planning; D001291:Attitude of Health Personnel; D002648:Child; D002983:Clinical Competence; D003142:Communication; D003162:Competency-Based Education; D003625:Data Collection; D019988:Children with Disabilities; D019538:Health Care Surveys; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data*; D018447:Medical Futility; D010166:Palliative Care / Q000379:methods / Q000592:standards*; D010372:Pediatrics / Q000193:education*; D008486:Physician Executives; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000379:methods / Q000592:standards*; D014481:United States