P3.R345: Pediatric End-of-Life Care Skills: An Interprofessional Workshop to Bridge Education Gap

Background: Pediatric end-of-life (EOL) is a high acuity, low occurrence, often distressing clinical scenario. Pediatric trainees rarely receive formal EOL skills training as part of their education yet may play an essential role in the care of critically ill and dying children. As a result, trainees often report feeling uncomfortable and inadequately prepared to discuss EOL goals and care. Skilled interprofessional teams are essential to provide quality care for dying children and their surviving family members. The pediatric end-of-life care skills (PECS) interprofessional workshop was developed to bridge this educational gap and provide the opportunity to practice the knowledge and skills required for effective pediatric EOL care.

Methods: PECS workshop was developed and designed by an interprofessional workgroup, including bereaved parent faculty, using a deliberate practice approach. Interprofessional trainees (pediatrics and medicine pediatrics residents, pediatric nurse practitioner students, masters of social work students, early career multidisciplinary members) were recruited to participate in a half-day PECS workshop. Following each four-hour workshop, participants completed a self-assessment survey of the change in their skill level before vs after the workshop. Questions targeted key knowledge elements and competencies in providing EOL care including the ability to engage in an interprofessional team. Responses on knowledge questions before versus after the workshop were rescored to indicate decreased knowledge, stability, or increased knowledge. All survey responses were summarized with count (%) and visualized with stacked bar plots. Participants were also asked to complete a free response portion on the survey. Preliminary inductive qualitative content analysis was conducted on free response questions. Only first-time participants were included in the analysis.

Results: 78 interprofessional trainees participated across 8 pilot PECS workshops, held over 2 years. All participants completed surveys. Survey self-assessment in nearly all domains remained stable or improved before versus after across disciplines (Figure 1). Key emerging themes of knowledge gained that participants intend to use in ongoing clinical practice include: importance and mechanics of interprofessional teamwork, the power of silence, and new communication skills including specific language to use in difficult conversations and emotional responses.

Conclusion: Interprofessional PECS workshops are an effective educational tool to improve confidence and self-reported competence in EOL care skills across disciplines. In addition, these workshops are an effective tool to build interprofessional teamwork skills in caring for critically ill and dying children. Further work will explore workshop sustainability as well as application and durability of learned skills in clinical practice.