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Palliative Care Training in an Obstetrics and Gynecology Residency: a Needs Assessment and Plan of Action

 Purpose: To perform a needs assessment for the development of a multidisciplinary palliative care curriculum for OBGYN residents.

Background: Palliative care improves patient quality of life, satisfaction, and survival. Although specialty palliative care services are increasing in number, any healthcare provider can and should utilize principles of primary palliative care in order to optimize patient care. OBGYN residents receive little formal education in palliative care skills, such as leading difficult conversations, symptom management, and end-of-life decision making. These skills are critical to OBGYN training and are incorporated into the ACGME milestones.  

Methods: OBGYN residents at a single institution were given an electronic survey assessing competency in palliative care skills and preferred modes of learning.  The survey was first piloted with OBGYN fellows.

Results: Of 41 surveyed residents, zero describe themselves as “competent” in reviewing advanced directives or counseling about comfort care. Only 7% describe themselves as competent in delivering serious news and 5% as competent in determining decision-making capacity. When asked specific questions about opioid dosing conversions, less than 20% answered correctly. The preferred teaching methods were clinical experiences, informal chalk talks, and lecture-based didactics. When asked explicitly, 92% agreed or strongly agreed that all OBGYN residents should undergo training in palliative care.

Discussions: OBGYNs care for women throughout their lifespan with challenging patient care situations requiring skills in communication, symptom management, and values determination. Our needs assessment highlights significant areas for improvement in the training of OBGYNs. We used this data to design and implement a multidisciplinary palliative care curriculum for OBGYN residents.

Topics: CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Patient Care, Medical Knowledge, Interpersonal & Communication Skills, GME,

General Information


Intended
Audience
Resident,Faculty,Residency Director,
Competencies
Addressed
Patient Care,Medical Knowledge,Interpersonal & Communication Skills,
Educational
Continuum
GME,
Educational
Focus
Clinical Focus

Author Information

Marisa Moroney, University of Colorado, Obstetrics and Gynecology; Lindsay Wheeler, MD; Jonathan Treem; Josephine H Amory, MD; Meredith Alston, MD; Carolyn Lefkowits, MD, MPH, MS

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