Objective:

We aimed to implement and assess the efficacy of a novel neuropalliative care curriculum using subjective resident self-assessments and a novel objective standardized clinical examination (OSCE). 

Background:

Neurologists care for patients with many palliative needs including communication and clarification of goals of care. Neurology residents, therefore, require education in these palliative care domains. Currently, no standardized curriculum exists for teaching and evaluating residents on these skills. We designed and implemented a neuropalliative care didactic curriculum using EPEC-N, a free and publicly available neuropalliative care education resource, and evaluated residents in several relevant skill areas using an original objective standardized clinical examination (OSCE).

Design/Methods:

We delivered 5 neuropalliative care didactic sessions in one academic year. Residents completed pre-curriculum surveys and post-curriculum surveys about their confidence in neuropalliative care topics. OSCE sessions were conducted for PGY-4 residents the year before introduction of this curriculum and after the curriculum, enabling comparison of two classes at the same stage of training. OSCE encounters were scored according to 28 pre-determined communication skills and domains.

Results:

On subjective self-assessments, more residents reported confidence in nearly all areas assessed including communication skills. PGY-4 residents performed better overall on this OSCE assessment following the neuropalliative care sessions, with a higher percentage of residents achieving full credit in 16 out of the 28 domains assessed. Particular areas of improvement included clarity of communication and building a therapeutic alliance with patients.

Conclusions:

Following the implementation of a neuropalliative care curriculum, neurology residents demonstrated improved self-assessed confidence in palliative care skills as well as improved objective performance of a variety of communication skills. Our curriculum and OSCE exam present a promising method of teaching, practicing and evaluating residents’ primary palliative care skills. Future projects may involve assessing the impact of this curriculum on resident interactions with patients and loved ones.