title: [Pediatric palliative care: a national survey of French pediatric residents' knowledge, education, and clinical experience].
abstract: BACKGROUND
  The need for educational training of healthcare professionals in palliative care is an important issue. Training and practice of pediatric residents in the field of pediatric palliative care (PPC) has never been assessed, although the organization of the medical curriculum in France is currently being revised.
  
  
  METHODS
  This study presents a national survey of pediatric residents, using a computerized anonymous questionnaire. Four different areas were studied: epidemiological data, theoretical and practical knowledge, education, and clinical experience in PPC.
  
  
  RESULTS
  The response rate was 39% (n=365/927). Whatever their age or regional location, 25% of residents did not know any details of the French law concerning patients' rights and the end of life. Experience with PPC starts very early since 77% of the first-year pediatric residents experienced at least one child in a palliative care and/or end-of-life situation. During their entire residency, 87% of the residents had experience with PPC and nearly all (96%) end-of-life care. Furthermore, 76% had participated in announcing palliative care (cancer, ICU, etc.) or a serious illness, and 45% had met and discussed with bereaved parents. Furthermore, while 97% of the pediatric residents received training in adult palliative care, mainly before their residency, only 60% received specific PPC training.
  
  
  CONCLUSIONS
  Ninety-six percent of all French pediatric residents encountered a PPC situation during their residency. That 77% of them had experienced PPC during their first year of residency shows the importance of early training in PPC for pediatric residents. Furthermore, this study points out that there is a significant lack in PPC training since 40% of all residents in the study received no specific PPC training. Progress in education remains insufficient in the dissemination of knowledge on the legal framework and concepts of palliative medicine: while the medical curriculum is being revised, we suggest that training in medical ethics and PPC should be introduced very early and systematically.
authors.affiliation: Centre d'action médico-sociale de Versailles, hôpital Mignot, 177, rue de Versailles, 78150 Le Chesnay, France. Electronic address: clefeubvre@ch-versailles.fr.
authors.forename: C
authors.initials: C
authors.lastname: Lefeubvre
authors.affiliation: Médecine palliative périnatale et pédiatrique, Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; EA 4569, laboratoire d'éthique médicale, université Paris Descartes, Sorbonne Paris Cité, 12, rue de l'École-de-Médecine, 75006 Paris, France.
authors.forename: M-L
authors.initials: ML
authors.lastname: Viallard
authors.affiliation: Institut d'hématologie et d'oncologie pédiatrique, ESPPéRA, 1, place Joseph-Renault, 69373 Lyon cedex 08, France.
authors.forename: M
authors.initials: M
authors.lastname: Schell
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010166:Palliative Care; D010372:Pediatrics / Q000193:education*; D011795:Surveys and Questionnaires; D055815:Young Adult