Pediatric residents' and fellows' perspectives on palliative care education.
BACKGROUND
The American Academy of Pediatrics recommends that pediatricians become knowledgeable in and comfortable with providing palliative care.


OBJECTIVE
The study goals included: determining the extent of training, knowledge, experience, comfort and competence in palliative care communication and symptom management of pediatric residents and fellows; obtaining residents' and fellows' views on key palliative care concepts; identifying topics and methods for palliative care education; and identifying differences in responses between residents and fellows.


METHODS
In academic year 2006-2007 pediatrics residents and fellows completed a survey on: training, experience, knowledge, competence, and comfort in delivering palliative care; palliative care practices; and suggestions for delivering palliative care education.


RESULTS
Fifty-two (60%) and 44 (62%) residents and fellows respectively completed the survey. Residents and fellows described none to moderate levels of training, experience, knowledge, competence and comfort in palliative care. Most respondents said they would benefit from more formal palliative care training. Respondents identified discussing prognosis, delivering bad news, and pain control as the three most important areas of needed education. Learning about supporting families spiritually and emotional support for physicians were among the least important educational areas identified. Respondents recommended delivering education via observation, bedside teaching, and participation in multidisciplinary groups.


CONCLUSIONS
Efforts to improve education in pediatric palliative care are needed. A palliative care team could facilitate palliative care education through engaging trainees in "real-life" interactions. The role of physicians in providing spiritual support and the need for educating physicians in obtaining emotional support for themselves merit further investigation.
Division of Pediatric Critical Care Medicine, Children's Memorial Hospital, Chicago, Illinois 60614-3394, USA. kmichelson@childrensmemorial.org
Kelly Nicole
KN
Michelson
Anne Daley
AD
Ryan
Borko
B
Jovanovic
Joel
J
Frader
D000328:Adult; D002983:Clinical Competence; D005257:Fellowships and Scholarships; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010372:Pediatrics / Q000193:education*; D014481:United States