A Child's Last Hours—Multidisciplinary Training in End-of-Life Care for Professionals Working in Children's Hospitals: Newborn With Lethal Congenital Anomalies

Keefer, Patricia; Pituch, Ken; Murphy, Terry; Azim, James; Trudeau, Cecilia; Saul, D'Anna; Marks, Adam; Lehmann, Katie; Hollenkamp, Elizabeth; Giacomazza, Maureen

doi:10.15766/mep_2374-8265.10108

Cited by 5 publications

(3 citation statements)

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“…Resources targeted to this learner population focused on teaching interprofessional communication skills or concepts more generally 9–11 or were targeted to specific clinical skills or acute scenarios, with a secondary emphasis on interprofessional collaboration. 12,13 For these reasons, we implemented a case-based exercise for medical students on their pediatrics core clerkship, as well as other health professions trainees, to explore interprofessional collaboration in the pediatrics context utilizing an interactive, discussion-based format.…”

Section: Introductionmentioning

confidence: 99%

Discharge Day: A Case-Based Interprofessional Exercise About Team Collaboration in Pediatrics

et al. 2019

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Introduction: Interprofessional education, which gives medical students the opportunity to learn from, with, and about other health professionals, is an essential component of the undergraduate medical education curriculum. Nonetheless, deliberate and sustained integration of interprofessional education into the undergraduate medical learning experience can be challenging, especially within the clinical setting. Methods: We implemented a 75-minute, interactive, collaborative, case-based conference focusing on an interprofessional clinical challenge in a pediatric setting. Medical students on their pediatrics core rotation and trainees within social work, nursing, pharmacy, and nutrition explored the concept of a team, reflected on roles, and considered how interprofessional collaboration could influence patient outcomes. Results: One hundred ninety-two health professions students participated in 15 sessions at three sites over a 10-month period (September 2017-July 2018). After each session, participants completed a session evaluation. They gave high ratings to the effectiveness and relevance of the experience and the case vignette. Responses to open-ended questions revealed that students had learned the importance of leveraging the expertise of team members and had resolved to speak up when faced with an interprofessional challenge in the future. Discussion: This case-based session is a logistically feasible and positively received opportunity for health professions students to discuss interprofessional collaboration. It could be adapted for a variety of learner populations and academic environments and could be incorporated into existing curricula.

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Section: Introductionmentioning

confidence: 99%

Discharge Day: A Case-Based Interprofessional Exercise About Team Collaboration in Pediatrics

et al. 2019

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“…We were unable to identify any pediatric curricula specifically on withholding or withdrawing medically provided nutrition and hydration; however, prior published curricula have included this topic within broader discussions of end-of-life care. 16,17 Curricula focused on ethical challenges in the NICU have utilized standardized patient encounters, an approach that was not feasible to implement within our general residency curriculum. 18,19 The AAP Section on Bioethics offers a curriculum that includes a session entitled Brain Death, Permanent Vegetative State, and Medical Futility.…”

Section: Introductionmentioning

confidence: 99%

Ethical Dilemmas at the Beginning and End of Life: A Needs-Based, Experience-Informed, Small-Group, Case-Based Curriculum for Pediatric Residents

Herbst

deSante-Bertkau

2020

MedEdPORTAL

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Introduction: Pediatric residents are faced with ethical dilemmas in beginning-and end-of-life situations throughout their training. These situations are innately challenging, yet despite recommendations that residents receive training in ethics and end-of-life domains, they continue to report the need for additional training. To address these concerns, we developed an interactive and reflective palliative care and medical ethics curriculum including sessions focusing on ethical dilemmas at the beginning and end of life. Methods: This module includes a trio of case-based, small-group discussions on artificial nutrition and hydration, futility, and ethical considerations in neonatology. Content was developed based on a needs assessment, input from local experts, and previously published material. Trainees completed assessments of comfort and understanding before and after each session. Results: The module was attended and assessed by an average of 27 trainees per session, including residents and medical students. Knowledge of ethical considerations improved after individual sessions, with 86% of trainees reporting understanding ethical considerations involved in the decision to withdraw or withhold medically provided nutrition and hydration and 67% of trainees reporting understanding the use of the term futility. Trainee comfort in providing counseling or recommendations regarding specific ethical issues demonstrated a trend toward improvement but did not reach statistical significance. Discussion: We successfully implemented this innovative module, which increased trainees' comfort with end-of-life care and ethical conflicts. Future studies should focus on the trainees' ability to implement these skills in clinical practice.

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“…Few peer-reviewed educational modules that are available for self-study exist on newborn or perinatal palliative care. Existing peer-reviewed educational resources include a case on newborn end-of-life care, 13 as well as a series of standardized patient neonatal ethics cases featuring a case on unexpected birth malformation. 14 In addition, simulation modules on delivering bad news targeted to neonatal-perinatal providers have been published.…”

Section: Introductionmentioning

confidence: 99%

Newborn Care Curriculum: Palliative Care for the Newborn

Anspacher

Burd²,

Stroh

et al. 2017

MedEdPORTAL

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IntroductionBecause pediatric hospitalists have increasing responsibilities in newborn hospitalization, training in perinatal palliative care is beneficial. A 2015 needs assessment revealed 68% of surveyed pediatric hospitalists were interested in more education on this topic. Thus, this learning module was designed to provide a concise, easy-to-use introduction to palliative care for the newborn.MethodsThis module was developed as part of the computer-based Newborn Care Curriculum to fill a gap in educational resources on perinatal palliative care. The primary tool in this learning module is a PowerPoint slide show with a script in the notes section. Using the presenter mode to view the PowerPoint slide show allows the learner to simultaneously view the slides and read the script for instruction. This module was tested by members of the pediatric hospitalist division at Children's National Health System in Washington, DC. Participants completed a pretest, posttest, and module evaluation. While tested as a self-study tool, the module may also be used in a small-group teaching setting.ResultsThe module was well received during the trial. The average posttest score was 96%, compared to pretest scores of 90%. Learners' comments were overwhelmingly positive, and constructive feedback has been addressed.DiscussionThis module provides pediatric hospitalists and others who care for newborns with a well-received introduction to perinatal palliative care. The computer-based format of the module adds to its uniqueness and utility.

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A Child's Last Hours—Multidisciplinary Training in End-of-Life Care for Professionals Working in Children's Hospitals: Newborn With Lethal Congenital Anomalies

Cited by 5 publications

References 0 publications

Discharge Day: A Case-Based Interprofessional Exercise About Team Collaboration in Pediatrics

Discharge Day: A Case-Based Interprofessional Exercise About Team Collaboration in Pediatrics

Ethical Dilemmas at the Beginning and End of Life: A Needs-Based, Experience-Informed, Small-Group, Case-Based Curriculum for Pediatric Residents

Newborn Care Curriculum: Palliative Care for the Newborn

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