Child Care :: Pediatricians in Training and End-of-Life Care – Better Prep is Needed

Researchers from the Johns Hopkins Children?s Center have found that while most pediatric residents have broached the subject of ending life support in terminally ill children, many feel neither comfortable nor sufficiently trained to discuss it.

?At some point, most pediatric residents face the difficult but necessary conversation on how and when to end life support for terminal patients, yet our study shows that many residents feel they are inadequately trained to conduct the conversation on their own,? says lead author Megan McCabe, M.D., a critical care specialist at the Children?s Center.

The study, which surveyed 40 pediatric residents at the Johns Hopkins Children?s Center, revealed that 93 percent of residents had encountered an end-of-life discussion at some point in their training. Of these, half were actively involved in the discussion, one-third were observers and 10 percent had to lead the discussion. Fewer than half of the residents reported being taught how to talk with patients and families about limiting or ending life support.

End-of-life care should be taught in medical school and continue throughout the residency, researchers advise, with special focus on trainees who are going through oncology or intensive-care unit rotations, where end-of-life discussions are most likely to occur.

Co-authors on the study: Elizabeth Hunt, M.D., and Janet Serwint, M.D., both of Hopkins.

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