Simulation Topics for Palliative Medicine Specialty Training: A Two-Phase Needs Assessment for Curriculum Development

Simulation-based learning is increasingly integrated into medical education; however, the use of simulation in palliative medicine is generally limited to ad hoc communication skills and pain management. There is a recognized need for a structured approach to a simulation-based curriculum aligned with the unique challenges in complex symptom management and emergencies in palliative medicine specialty training.

To identify and prioritize key clinical topics for a simulation curriculum for palliative medicine specialty training.

Using Kern's six-step approach to curriculum development, we conducted a two-phase needs assessment. Phase 1 was a survey of 101 palliative care practitioners to identify topics appropriate for more intensive training. Phase 2 applied the Delphi method with 46 participants to achieve consensus on priorities.

Ten high-priority simulation topics emerged: dyspnea crisis, complex pain management, acute pain crisis, terminal agitated delirium, airway obstruction, existential distress, palliative sedation, intractable nausea and vomiting, opioid use disorder, and ventilatory support withdrawal. These aligned with competency-based and entrustable professional activities.

This study addresses the gaps in simulation use for complex and emergent clinical situations. Next steps include validation with residency program directors, mapping existing resources, and developing new content, supporting a collaborative approach to advancing palliative specialty education.