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Pediatric residents manage many dying children and deliver difficult news, yet their training programs lack sufficient psychosocial education. This highlights a critical gap in preparing future physicians for end-of-life care in pediatrics.
Area of Science:
- Pediatric Medicine
- Medical Education
- Palliative Care
Background:
- Pediatric residents gain significant clinical experience with chronically ill and dying children.
- Current pediatric residency curricula may not adequately address the psychosocial aspects of end-of-life care.
Purpose of the Study:
- To assess the clinical experience of pediatric residents in managing dying children.
- To evaluate the psychosocial educational curriculum related to end-of-life care in pediatric residency programs.
- To identify disparities between clinical experience and educational emphasis.
Main Methods:
- Individual retrospective interviews with 36 third-year pediatric residents from four Western university programs.
- Data collection focused on clinical management of dying children and curriculum content.
Main Results:
- Residents managed an average of 35 dying children and informed 33 families about fatal diagnoses during their first 2.5 years.
- A notable discrepancy exists between the volume of clinical experience and the curriculum's focus on these sensitive issues.
Conclusions:
- Pediatric residency training requires enhancement in psychosocial education for end-of-life care.
- Improved curricula are necessary to better equip residents for supporting terminally ill children and their families.
Abstract:
Thirty-six third-year pediatric residents at four Western university training programs were interviewed individually and retrospectively about the magnitude of their clinical experience in managing the treatment of chronically ill and dying children, as well as the psychosocial educational curriculum of their training program as it pertained to these experiences. The residents managed an average of 35 dying children during their first 2 1/2 years of pediatric residency. They imparted the news of a potentially fatal disease to an average of 33 families during this same time span. There was a disparity between the magnitude of the clinical experience and the time and emphasis on these issues in the residency curriculum. The implications of these findings for an improved educational curriculum in the psychosocial care of dying children are discussed.