Palliative and Supportive Care

Original Articles

A longitudinal method of teaching pediatric palliative care to interns: Preliminary findings regarding changes in interns' comfort level

Shahram Yazdania1 c1, Elana Evana1, Danielle Roubinova1, Paul J. Chunga2 and Lonnie Zeltzera3

a1 Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California

a2 Department of Pediatrics, UCLA/RAND Center for Adolescent Health Promotion, Los Angeles, California

a3 Pediatric Pain Program, Mattel Children's Hospital, Los Angeles, California

Abstract

Objective: A longitudinal pediatric palliative care curriculum was introduced into the pediatric residency program at the University of California, Los Angeles. The present study explores the possible effects of this curriculum on the interns' self-assessed comfort levels regarding caring for children with life-threatening conditions.

Methods: A newly created assessment tool was administered to interns in order to rate their comfort regarding pediatric palliative care at the beginning and conclusion of their intern year.

Results: Twenty-two of the 29 interns completed this survey. Baseline data indicated 55% of the interns had some experience with taking care of a dying pediatric patient during their medical school training, and 79% indicated that they had taken care of a dying adult. Only 7% of the interns felt adequately prepared to deal with death and dying, but all interns indicated interest in further learning about pediatric palliative care. Comparison of the overall comfort levels of the 22 responding residents before and after the first year of training in 20 different related tasks demonstrated a significant self-assessed improvement of comfort in seven areas. There was no increase in self-reported comfort in communication related to palliative care.

Significance of results: Residents indicated increased comfort in some areas of pediatric palliative care after the first year of their training. The underlying cause of this increased comfort is unclear at this time. The overall effect of longitudinal palliative care curriculums on residents' level of comfort in caring for this population deserves further assessment.

(Received April 01 2009)

(Accepted April 19 2009)

Correspondence:

c1 Address correspondence and reprint requests to: Shahram Yazdani, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095-1752. E-mail: syazdani@mednet.ucla.edu