Current Landscape of Palliative Care Education in Neurocritical Care Fellowship Programs in the United States: A Survey-based Study
Karishma Popli1, Caitlyn D. Ahlberg2, Corey Tapper2, Danielle J. Doberman2, J. Ricardo Carhuapoma1, Ambereen K. Mehta2
1Department of Neurology, 2Department of Medicine, Johns Hopkins University School of Medicine
Objective:

This study assesses the current palliative care (PC) education incorporated in neurocritical care (NCC) fellowship programs in the United States (US).

Background:

The Accreditation Council for Graduate Medical Education requires incorporation of PC education in Neurology residency curricula, but not for NCC fellowship training programs despite PC playing an integral role in many NCC scenarios.

Design/Methods:
An anonymous survey was adapted from a previously published survey developed by one of the authors (AKM). The survey was adjusted after the authors (CDA, CXT) performed field testing to establish face validity. Field testing was performed with specialists in Neurology and Pulmonary Critical Care Medicine. The Neurocritical Care Society (NCS) distributed it to 116 program directors associated with 75 programs with a request for voluntary participation.
Results:

NCC fellowship program survey completion rate was 35% with 23% completed by program directors. Amongst 22 NCC programs, only 4.5% had faculty with formal PC training, but 95% of programs stated they offered some form of PC education. Diverse teaching methodologies were used: conferences (30%), role playing or simulation (22%), and standardized patients (5%) with 60 survey responses. Program directors from 20 programs identified the most important PC concepts needed during fellowship were how to discuss prognostication (95%), deliver bad news (85%), and discuss withdrawing/withholding life-prolonging therapies (80%). When asked how prepared NCC fellows are to manage these PC topics, 50% stated extremely well prepared to deliver bad news, and 45% stated extremely well prepared for discussing prognostication and withdrawing/withholding life-prolonging therapies.

Conclusions:

Our results provide an assessment of the existing PC education gaps, as well as opportunities to improve the integration of PC education in NCC fellowship curricula. Such integration is of high priority given the complex nature of diagnosis, prognostication, and decision making within this field.

10.1212/WNL.0000000000212588
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.