title: Developing competencies for pediatric hospice and palliative medicine.
abstract: In 2006, hospice and palliative medicine (HPM) became an officially recognized subspecialty. This designation helped initiate the Accreditation Council of Graduate Medical Education Outcomes Project in HPM. As part of this process, a group of expert clinician-educators in HPM defined the initial competency-based outcomes for HPM fellows (General HPM Competencies). Concurrently, these experts recognized and acknowledged that additional expertise in pediatric HPM would ensure that the competencies for pediatric HPM were optimally represented. To fill this gap, a group of pediatric HPM experts used a product development method to define specific Pediatric HPM Competencies. This article describes the development process. With the ongoing evolution of HPM, these competencies will evolve. As part of the Next Accreditation System, the Accreditation Council of Graduate Medical Education uses milestones as a framework to better define competency-based, measurable outcomes for trainees. Currently, there are no milestones specific to HPM, although the field is designing curricular milestones with multispecialty involvement, including pediatrics. These competencies are the conceptual framework for the pediatric content in the HPM milestones. They are specific to the pediatric HPM subspecialist and should be integrated into the training of pediatric HPM subspecialists. They will serve a foundational role in HPM and should inform a wide range of emerging innovations, including the next evolution of HPM Competencies, development of HPM curricular milestones, and training of adult HPM and other pediatric subspecialists. They may also inform pediatric HPM outcome measures, as well as standards of practice and performance for pediatric HPM interdisciplinary teams.
authors.affiliation: Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia; jeffrey.klick@choa.org.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Klick
authors.affiliation: Akron Children's Hospital, Northeast Ohio Medical University, Rootstown, Ohio;
authors.forename: Sarah
authors.initials: S
authors.lastname: Friebert
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland;
authors.forename: Nancy
authors.initials: N
authors.lastname: Hutton
authors.affiliation: Children's Hospital and Clinics of Minnesota, Minneapolis, Minnesota;
authors.forename: Kaci
authors.initials: K
authors.lastname: Osenga
authors.affiliation: Mott Children's Hospital, The University of Michigan School of Medicine, Ann Arbor, Michigan;
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Pituch
authors.affiliation: Hospice of the North Shore & Greater Boston, Danvers, Massachusetts;
authors.forename: Tamara
authors.initials: T
authors.lastname: Vesel
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio;
authors.forename: Norbert
authors.initials: N
authors.lastname: Weidner
authors.affiliation: Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; and.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Block
authors.affiliation: Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Morrison
mesh_terms: D000068:Accreditation; D002648:Child; D002983:Clinical Competence / Q000592:standards*; D003299:Cooperative Behavior; D003479:Curriculum / Q000639:trends; D004503:Education, Medical, Graduate / Q000639:trends; D017144:Focus Groups; D005544:Forecasting; D017051:Hospice Care / Q000592:standards* / Q000639:trends; D006801:Humans; D033183:Interdisciplinary Communication; D065126:Palliative Medicine / Q000193:education* / Q000639:trends; D010372:Pediatrics / Q000193:education* / Q000639:trends; D012955:Societies, Medical; D013038:Specialization / Q000639:trends; D013044:Specialty Boards / Q000592:standards / Q000639:trends; D013727:Terminal Care / Q000592:standards / Q000639:trends; D014481:United States
keywords: competencies; fellowship training; hospice and palliative medicine; milestones; pediatric palliative care