Piloting the first pediatric-specific serious illness conversation program training at Baylor Scott & White

The need for advanced care planning in pediatrics is becoming more recognized as children live longer with chronic illnesses. In April 2023, the first cohort of pediatric residents in the Baylor Scott & White system underwent Serious Illness Conversation Program (SICP) training. This quality improvement project aimed to increase pediatric residents' confidence in conducting serious illness conversations and increase the number of conversations led by pediatric residents within 6 months of undergoing SICP training.

An in-person half-day SICP training session was conducted by the palliative care team. Fourteen pediatric residents attended the session. A posttraining survey was taken to assess participants' impressions before and after the training, rating SICP elements on a Likert scale of confidence from 1 (low) to 7 (high). The same questionnaire was administered 6 months later to determine the longitudinal effect of the training.

After the training session, residents' self-perceived confidence levels of starting a serious illness conversation significantly increased from an average of 2.1 to 4.9 (P < 0.01). Confidence levels of eliciting a patient's thoughts and goals increased from 3.5 to 6.1 (P < 0.01). Six months later, confidence ratings remained significantly increased compared to pretraining levels, with averages of 4.5 and 5.3, respectively (P < 0.01). The quantity of serious illness conversations conducted remained low.

Pediatric residents' self-perceived confidence levels increased significantly immediately after SICP training and remained elevated 6 months later; however, the number of SICP conversations taking place did not change.