Developing a Cross-Discipline Evidence-Based Palliative Care Curriculum for Pediatric, Neurology, Anesthesia and ICU Residents
CCCF ePoster library. Stewart S. 11/01/16; 150964; 83
Dr. Samuel Stewart
Dr. Samuel Stewart
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Topic: Education

Developing a Cross-Discipline Evidence-Based Palliative Care Curriculum for Pediatric, Neurology, Anesthesia and ICU Residents

Stewart, SH.1; Gofton, TE2; Schulz, V3; Sarpal, A1

1Department of Paediatrics, Western University, London, Canada; 2Department of Clinical Neurosciences, Western University, London, Canada; 3Department of Anaesthesia, Western University, London, Canada

Grant acknowledgements:
Academic Medical Organization of Southwestern OntarioSt. Joseph's Health Care, London Ontario


Introduction: All graduating residents require general palliative care skills.  In Canada, there is currently no standardized palliative care curriculum for specialty residents. Intensive care providers, in particular face unique challenges in the provision of palliative care.
Objective: Develop a multi-faceted, evidence-based palliative care curriculum designed to provide paediatric, neurology, anaesthesia and ICU residents with the general palliative care skills required for providing patient care along the continuum of life. 

Methods: The study is underway in a single Canadian training centre. A needs assessment was initially performed.  Focus groups in neurology were held with physicians, allied health and senior residents; semi-structured interviews were held with patients and caregivers. All residents from paediatrics, neurology, anaesthesia and ICU were approached for participation. Residents were asked to complete the Kolb learning style inventory (LSI) which was used to determine the learning styles of various specialty residents.  They subsequently completed questionnaires on breaking bad news (BBN); a knowledge test; and the Palliative Medicine Comfort and Confidence Survey. Surveys were conducted either in person, or online.

Results: Based on the Kolb LSI, 5/7 (71.4%) of ICU residents are 'convergers,' 9/16 (56.3%) of neurology residents are 'assimilators,' while paediatric and anaesthesia residents were more evenly distributed across the four learning styles (assimilating, accommodating, diverging and converging). Within paediatrics, ninety percent of residents requested additional training in BBN; fewer than ten percent strongly agreed with the statement 'I feel confident in my ability to break bad news.' General principals identified for curriculum inclusion included: symptom management, communication, psychosocial aspects of care, care coordination and access, and myths and pitfalls in palliative care.   

Conclusion: This project identifies various learning styles and establishes baseline palliative care knowledge of paediatric, neurology, anaesthesia and intensive care residents. The information obtained will serve in the development of a novel, multi-faceted, cross-discipline palliative care curriculum based on expert opinion, review of the royal college objectives and resident input. In order to maximize knowledge up take, the results of the Kolb LSI will be used to match curriculum delivery method to resident learning styles. Post-implementation surveys will be used to measure the effectiveness of the new curriculum.


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