Ross Mindy K, Doshi Ami, Carrasca London, Pian Patricia, Auger JoAnne, Baker Amira, Proudfoot James A, Pian Mark S
Division of Pediatric Pulmonary and Sleep Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
Division of Hospitalist Medicine, UCSD, Rady Children's Hospital, San Diego, CA, USA.
Int J Pediatr. 2017;2017:7568091. doi: 10.1155/2017/7568091. Epub 2017 Feb 12.
. There is a need for increased palliative care training during pediatric residency. . In this pilot study, we created a comprehensive experiential model to teach palliative care skills to pediatric residents. Our Comfort Care Modules (CCMs) address pediatric palliative care (PPC) topics of breaking bad news, dyspnea, anxiety, pain management, and the dying child. We also evaluated a scoring system and gathered qualitative data. . The CCMs are part of the University of California San Diego pediatric residency's second-year curriculum. Comparisons were made for statistical trends between residents exposed to the modules ( = 15) and those not exposed ( = 4). . Nineteen of 36 residents (52%) completed surveys to self-rate their preparedness, knowledge, and confidence about PPC before and after the intervention. Resident scores increased in all areas. All improvements reached statistical significance except confidence when breaking bad news. Overall, the resident feedback about the CCMs was positive. . This study demonstrates that the CCMs can be performed effectively in an academic setting and can benefit residents' self-perception of preparedness, confidence, and knowledge about pediatric palliative care. In the future, we plan to implement the modules on a larger scale. We encourage their use in interprofessional settings and across institutions.
儿科住院医师培训期间需要增加姑息治疗培训。在这项试点研究中,我们创建了一个全面的体验式模型,向儿科住院医师传授姑息治疗技能。我们的舒适护理模块(CCM)涉及儿科姑息治疗(PPC)的主题,如告知坏消息、呼吸困难、焦虑、疼痛管理以及濒死儿童。我们还评估了一个评分系统并收集了定性数据。CCM是加利福尼亚大学圣地亚哥分校儿科住院医师第二年课程的一部分。对接触过这些模块的住院医师(n = 15)和未接触过的住院医师(n = 4)之间的统计趋势进行了比较。36名住院医师中有19名(52%)完成了调查,以自我评估他们在干预前后对PPC的准备程度、知识和信心。住院医师在所有领域的得分都有所提高。除了告知坏消息时的信心外,所有改进都达到了统计学意义。总体而言,住院医师对CCM的反馈是积极的。这项研究表明,CCM可以在学术环境中有效实施,并可以提高住院医师对儿科姑息治疗的准备程度、信心和知识的自我认知。未来,我们计划更大规模地实施这些模块。我们鼓励在跨专业环境和不同机构中使用它们。