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Educational Perspectives: Palliative Care Education in Neonatal-Perinatal Medicine Fellowship
Katie R Forman1, Alecia Thompson-Branch1
1Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital of Montefiore, Bronx, NY.
Insights
Neonatal palliative care training is crucial for improving care for high-risk newborns. Neonatal-perinatal medicine programs should implement formal palliative care education to support neonates with life-limiting illnesses.
Area of Science:
- Neonatal Medicine
- Palliative Care
- Medical Education
Background:
- The neonatal period (birth to 28 days) has a high risk of mortality.
- Congenital anomalies and prematurity are leading causes of neonatal death.
- Many neonates die in intensive care despite aggressive interventions.
Purpose of the Study:
- To review neonatal palliative care concepts.
- To highlight the lack of formal palliative care education in neonatology.
- To propose methods for formalizing palliative care training in neonatal-perinatal medicine.
Main Methods:
- Literature review on palliative care in neonates.
- Analysis of current trends in pediatric palliative care education.
- Exploration of educational strategies and success metrics.
Main Results:
- Palliative care integrates curative and supportive measures, focusing on family and comfort.
- Existing pediatric palliative care recommendations often focus on disease mitigation.
- There is a significant gap in formal palliative care training for neonatologists.
Conclusions:
- Neonatal-perinatal medicine training programs need to develop formal palliative care curricula.
- Enhanced training will better equip neonatologists to care for critically ill neonates.
- Formal education is essential for providing comprehensive care to neonates with life-limiting conditions.
Abstract:
The neonatal period from birth to less than or equal to 28 days is one of increased risk of death. Congenital anomalies and prematurity are 2 of the most common risk factors for death at this early age. Many of these neonates will die in an intensive care unit, some with full resuscitative efforts being undertaken despite the understanding that these actions are highly unlikely to yield an outcome different from death. Palliative care allows curative therapies to be provided alongside supportive techniques such as enhanced family communication, attention to spirituality and the psychosocial health of the family, management of symptoms other than those specific to the underlying disease process, and enhancing comfort. The American Academy of Pediatrics has set forth recommendations related to pediatric palliative care for the various pediatric subspecialties; however, much of the focus is on disease processes and curing or mitigating various illnesses. Given the high preponderance of death in the neonatal period, neonatal-perinatal medicine training programs should be tasked with generating formal palliative care training. Such training should be geared to providing better care for neonatal patients with a life-limiting or life-altering illness, and better equipping future neonatologists with the tools needed to provide truly comprehensive care for their sickest patients at risk for death and disability. This article serves to review the concept of palliative care in neonates, discuss the paucity of formal education in palliative care, explore the general trend in palliative care education, review various ways in which palliative care education can be formalized, and define metrics of a successful educational program.