Improving paediatric advance care planning: Results of a learning needs analysis and simulation-based education...

Area of Science:

• Pediatric Palliative Care
• Medical Education
• Healthcare Professional Training

Background:

• Advance care planning (ACP) is vital for children with life-limiting conditions.
• Clinician confidence and preparedness for ACP discussions are often suboptimal.
• Barriers to timely ACP include lack of training and uncertainty about when/how to initiate conversations.

Purpose of the Study:

• To evaluate clinicians' experience, attitudes, and confidence regarding ACP.
• To identify learning needs and barriers related to paediatric ACP.
• To develop and assess the feasibility of simulation-based education for ACP.

Main Methods:

• An electronic learning-needs survey was distributed to medical, nursing, and allied health clinicians.
• Survey results informed the design of a simulation-based education session.
• The education session was piloted with the Oncology Department at a quaternary paediatric referral centre.

Main Results:

• 157 surveys revealed that while most clinicians had prior ACP experience, only 40-45% felt confident or prepared.
• Key barriers included not knowing when or what to say during ACP discussions.
• Post-simulation education, 90% of participants reported increased confidence in participating in ACP discussions.

Conclusions:

• Lack of clinician training contributes to delayed paediatric ACP conversations.
• Simulation-based education is a feasible and effective tool for enhancing clinician understanding and confidence in ACP.
• Targeted educational interventions can improve the quality and timeliness of ACP for children.