Development of an Interprofessional Clinician Training in Pediatric Serious Illness Communication

Abstract

Background: Early advance care planning (ACP) is associated with improved outcomes in pediatrics, yet few rigorously developed curricula exist to train interprofessional clinicians in ACP communication. Objectives: To develop, pilot and evaluate an evidence-based virtual clinician training in a pediatric serious illness communication program (PediSICP) to facilitate ACP. Primary outcomes were learner self-assessment of skills attainment and training program satisfaction. Methods: We developed an interactive, skills-based three-hour synchronous online clinician training program using Kern's Six-Step Curriculum Design, incorporating didactic and simulated patient encounters with a trained actor. Specific, measurable cognitive and behavioral learning objectives were to improve knowledge of the evidence-based benefits of ACP, to describe the PediSICP framework, and to improve practice by demonstrating a simulated ACP conversation using a goals and values approach. Sub-objectives include responding to emotion and sharing prognosis using "wish/worry" statements. Results: We conducted 10 virtual trainings from April to December 2021, each with 2-8 participants (n = 40), including 27 physicians, 7 nurse practitioners, 5 nurses, and 1 respiratory therapist from critical care, cardiology, pulmonary, and complex care; 62.5% reported no prior formal ACP communication training. Following training, 97% of participants were highly satisfied with training quality, and 100% endorsed that they would recommend it to colleagues. Additionally, clinician self-reported comfort discussing fundamental elements of ACP significantly increased following the training. Conclusion: Teaching ACP communication virtually to pediatric interprofessional clinicians is both feasible and acceptable, with improvements described in self-reported knowledge and comfort discussing elements of ACP. Future research will test the efficacy of PediSICP to facilitate longitudinal ACP.

Keywords: conversation guides; curriculum development; interprofessional education; pediatric advance care planning; primary palliative care; serious illness.