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Palliative Care Education in Pediatric Cardiology Fellowships: A Survey of Program Directors

Lesje DeRose1, Sarah Godfrey2, Shabnam Peyvandi3

  • 1University of California San Francisco Benioff Children's Hospitals, San Francisco, CA, USA. lesje.derose@ucsf.edu.

Pediatric Cardiology
|June 21, 2025
PubMed

Insights

Pediatric cardiology programs have limited palliative care (PC) education, with many program directors unsatisfied. Standardized PC training is needed for fellows caring for children with advanced heart disease.

Area of Science:

  • Pediatric Cardiology
  • Palliative Care
  • Medical Education

Background:

  • Advances in treating severe congenital heart disease increase the population of children and adults with advanced heart conditions.
  • Palliative care (PC) is crucial for these patients, yet PC education within pediatric cardiology fellowship training is lacking.
  • This study addresses the current state of PC education in pediatric cardiology fellowships.

Purpose of the Study:

  • To assess the current landscape of palliative care education in pediatric cardiology fellowship programs nationwide.
  • To identify program directors' satisfaction levels and perceived barriers to PC education.
  • To determine the need for standardized PC training recommendations.

Main Methods:

  • A cross-sectional survey was distributed to 58 pediatric cardiology fellowship program directors (PDs).
  • The survey assessed the availability and format of PC didactic education, simulation, bedside teaching, and dedicated rotations.
  • Data on PD satisfaction, barriers, and perceived fellow competency in key PC skills were collected.

Main Results:

  • A 48.3% response rate was achieved (28 PDs).
  • PC didactics were reported in 71.4% of programs, primarily delivered by PC specialists.
  • Satisfaction with PC education quantity was low (53.8%), though quality satisfaction was higher (76.9%). Key barriers included curriculum overload and lack of faculty expertise. Deficiencies were noted in fellow competency in advance care planning and critical illness communication.

Conclusions:

  • There is significant variability in palliative care education practices across pediatric cardiology fellowship programs.
  • Program directors express dissatisfaction with the current amount of PC education and face barriers to its implementation.
  • There is a clear need for standardized palliative care training recommendations and curriculum development to improve fellow preparedness in managing complex pediatric heart conditions.

Keywords:
Advanced heart diseaseCongenital heart diseaseFellowship educationPalliative care

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