Educational Needs Among Pediatricians Regarding Caring for Terminally Ill Children

Abstract

BackgroundAccording to the Accreditation Council on Graduate Medical Education and the Ambulatory Pediatrics Association, pediatricians need to be instructed in caring for terminally ill children as a part of residency training. However, a systematic approach to education in end-of-life care is lacking in most residency programs.ObjectivesTo assess pediatricians' self-perception of their coping skills regarding death and dying at The New York Hospital–Cornell Medical Center, New York City, NY, if they felt further support and education were needed in this area, and which modes of instruction respondents thought would be most useful.MethodsData based on a questionnaire distributed to pediatricians at The New York Hospital are presented.ResultsThe following topics are discussed: (1) existing level of education and support in caring for terminally ill patients; (2) attitudes of pediatricians regarding discussions of diagnosis and prognosis with dying children and their families; (3) pediatricians' perceived need to limit emotional involvement with terminally ill children; (4) attendance of funeral or memorial services of patients by pediatricians; (5) experience of patient death as a failure; and (6) expressed need for support and instruction in death and dying based on level of training.ConclusionEducational interventions and support in this area are needed.

Pediatric Residents' and Fellows' Perspectives on Palliative Care Education

“…Our findings contrast with those from other studies, in which residents expressed the need for additional support 5,14. Possible explanations for our results include: trainees at our institution recognized their need to learn how to cope emotionally, but they simply valued education in this area less than other areas; trainees at our institution feel adequately supported; and/or our trainees might not appreciate the emotional impact that caring for dying children can have.…”

Home-Based Palliative Care for Children With Incurable Cancer: Long-term Perspectives of and Impact on General Practitioners

“…This finding is consistent with previous studies in health care professionals [33][34][35][36][37][38][39][40][41] . Liben and colleagues previously reported that healthcare professionals often rely upon colleagues for support more than their family and friends 45 , whereas we found that GPs generally receive support from own family members and-to a lesser extent-their colleagues.…”

End-of-Life Care Education in Pediatric Critical Care Medicine Fellowship Programs: Exploring Fellow and Program Director Perspectives

“…6 We found that fellows wanted to learn about emotional and moral issues. The findings on the importance of emotional support are similar to the findings of Kolarik et al and Khaneja and Milrod, but differ from findings of Michelson et al 14,22,26…”

“…6 We found that fellows wanted to learn about emotional and moral issues. The findings on the importance of emotional support are similar to the findings of Kolarik et al and Khaneja and Milrod, but differ from findings of Michelson et al 14,22,26 This may be due to the vulnerability and exposure to highacuity cases seen by PCCM fellows. Legal issues such as completion of a death certification and ramifications of court decisions in death pronouncement were another area in which PCCM fellows wanted more education.…”