Creation of a novel simulation based palliative care curriculum for the emergency medicine resident

Palliative Care focuses on improving quality of life and preventing suffering, especially near the end of life. With an aging population that frequently seeks care in the Emergency Department (ED), it is crucial for Emergency Medicine (EM) physicians to be well versed in the skills needed for palliative care. However, many EM residency programs lack formal training in this area. This study aimed to develop, implement, and assess a year-long, simulation-based palliative care curriculum.

This IRB-exempt observational cohort study was conducted from July 2023 to June 2024 at a large urban EM residency program. A group of content experts in palliative care and simulation-based education designed the curriculum utilizing the Kern model of curriculum development, integrating simulation, small group discussion, and didactic lectures. The curriculum was delivered episodically throughout the academic year during regular residency didactics. The curriculum's impact on knowledge, attitudes, and practice patterns regarding palliative care was assessed using pre- and post- intervention surveys.

Fourteen EM residents completed both pre- and post-intervention surveys. There was a statistically significant improvement in self-reported practice patterns (35.7% to 60.7% p = 0.0055), but no significant change in attitudes (73.4% to 73.4% p = 0.5020) or knowledge (48.9% to 57.1% p = 0.0758).

A year-long simulation-based palliative care curriculum significantly improved EM residents' practice patterns in regard to palliative care, with a positive trend in knowledge retention. Feasibility of implementation was demonstrated. Findings suggest that simulation-based training effectively teaches key palliative care skills. This curriculum may serve as a model for integrating palliative care education into other EM residency programs and may improve resident preparedness in caring for critically ill patients near the end of life.