Needs-driven Simulation Education: Advancing Neuropalliative Communication for Neurology Residents
Katherine Makaroff1, Jessica Besbris2, Daniel Karlin1, Alice Hawkins3, Alex Aw4, Nathan Chu1, Cara Siegel1
1UCLA David Geffen School of Medicine, 2Cedars-Sinai Medical Center, 3Mount Sinai Health System, 4Cedars Sinai
Objective:
To develop and evaluate a structured neuropalliative care curriculum aimed at improving neurology residents’ confidence in primary palliative care skills.
Background:
Palliative care training in neurology residency programs remains limited, despite the high symptom burden, complex illness trajectories, prognostic uncertainty, and decisional capacity challenges faced by patients with neurologic disease.
Design/Methods:
A needs assessment was conducted in 2020 among adult neurology residents to evaluate exposure to key palliative care competencies. Findings informed the development of a structured neuropalliative care curriculum, implemented annually from 2020–2025 at two large academic medical centers. The curriculum consisted of didactic sessions and a novel simulation-based communication workshop. Residents practiced serious illness conversations emphasizing three core neuropalliative skills: discussing prognostic uncertainty in neurologic recovery, providing empathic responses, and engaging in shared decision-making, including the use of time-limited trials of life-sustaining interventions. Pre- and post-intervention surveys assessed self-reported comfort across six palliative care domains using a five-point Likert scale. Paired and unpaired statistical tests were used to evaluate changes in confidence.
Results:
Fifty-eight residents participated in the full educational program, and fifteen completed the initial needs assessment. Across all palliative care domains, trainees rated the importance of these skills significantly higher than their confidence in performing them. Following the intervention, mean self-reported comfort increased by an average of 0.6 points across all six domains (pre-intervention n=58; post-intervention n=41).
Conclusions:
A structured, simulation-based neuropalliative care curriculum improved residents’ confidence in providing primary palliative care. This approach offers a feasible and effective model for incorporating palliative care training into neurology residency programs.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.