Teaching Palliative Care Skills Using Simulated Family Encounters

Abstract

Abstract While there has been a steady increase in awareness of end-of-life issues and palliative care for adults, there continues to be a shortfall in pediatric palliative care education, particularly for physicians in training. This resource is a curriculum intervention developed to train pediatric residents on pediatric palliative care and end-of-life discussions. Teaching the skill of delivering bad news and offering palliative care options has been challenging for physicians. Allowing trainees to lead end-of-life discussions poses a risk of psychological harm to the family, if done poorly. Using a simulated encounter and standardized families to allow trainees to practice these skills was found to be an effective method of resident education. During the 2009–2010 residency year, we conducted a study of our first- to third-year pediatric residents, using surveys of self-efficacy to compare the differences between residents who received simulator exposure and those who did not. Residents who completed simulation training were three times more likely to give a positive comfort response than residents who did not complete training when suggesting to a family that an end-of-life discussion was needed. On exit interviews, residents who participated in the simulated encounters reported that the feedback they received from both the actors and the impartial observers was valuable and would help improve the way they led family meetings in the future.

Keywords

• Terminal Infant