Development, Implementation, and Evaluation of a Novel Neuropalliative Care Education Curriculum
Karishma Popli1, S. Ian Borrison2, Ashley Paul1, Corey Tapper2, J. Ricardo Carhuapoma1, Ambereen Mehta2
1Department of Neurology, 2Department of Medicine, Johns Hopkins University School of Medicine
Objective:

This study aimed to develop and evaluate a novel, scalable neuropalliative care curriculum for neurocritical care fellows, with expansion planned across neurology residency and subspecialty programs.

Background:
Neurologic illnesses involve high symptom burden, complex prognostication, and emotionally charged decision-making, making palliative care (PC) skills essential for neurologists. Despite national recommendations, formal neuropalliative care training remains limited. A prior needs assessment revealed that only 4.5% of U.S. neurocritical care (NCC) fellowship programs had faculty with formal PC training, and many fellows felt underprepared in communication, prognostication, and discussions of life-sustaining treatments.
Design/Methods:

An interdisciplinary curriculum was piloted for NCC fellows over three academic years (2022–2025), combining asynchronous didactics from the Education in Palliative and End-of-Life Care for Neurology (EPEC-N) curriculum with in-person, simulation-based training using VitalTalk communication techniques. Simulation scenarios, co-developed by NCC and PC faculty, reflected realistic clinical challenges. Building on pilot success, subspecialty-specific simulations were created using Kern’s Six-Step Curriculum Development framework and situated learning theory. A prospective mixed-methods design, including pre/post surveys, simulation assessments, and qualitative interviews, was used to evaluate feasibility, engagement, and impact.

Results:

Preliminary findings demonstrate high learner engagement and improved self-reported preparedness in serious illness communication. Fellows reported greater confidence in delivering bad news, discussing prognosis and code status, and managing emotional conversations. Program directors identified prognostication (95%), delivering bad news (85%), and withdrawal-of-care discussions (80%) as top educational priorities. Data collection and analysis are ongoing.

Conclusions:

This curriculum introduces an innovative, simulation-based approach to neuropalliative care education tailored to neurology subspecialties. Grounded in evidence-based communication frameworks, it addresses a critical training gap and demonstrates feasibility and positive impact on learner confidence. Future directions include national dissemination and integration across neurology training programs to establish a sustainable, standardized model for neuropalliative care education.

10.1212/WNL.0000000000217541
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