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Abstract: PO2010

Palliative Care Training in Pediatric Nephrology Fellowship: A Cross-Sectional Survey

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • House, Taylor R., University of Washington, Seattle, Washington, United States
  • Wightman, Aaron G., University of Washington, Seattle, Washington, United States
  • Smith, Jodi M., University of Washington, Seattle, Washington, United States
  • Rosenberg, Abby R., University of Washington, Seattle, Washington, United States
Background

The integration of primary palliative care (PC) in pediatric nephrology provides an opportunity to address the burdens faced by children with chronic kidney disease (CKD) and their families. Incorporation of PC education in training programs is recommended, but adult nephrology fellows report inadequate preparation to engage in primary PC. Similar experience of pediatric nephrology fellows is unknown. We sought to describe pediatric nephrology fellows’ knowledge and confidence in providing primary PC and PC education received during training.

Methods

A cross-sectional web-based survey was administered to pediatric nephrology fellows associated with the American Society of Pediatric Nephrology listserv. Three invitations were sent from May 3, 2021 to May 28, 2021. The survey was adapted from a previously validated instrument and pretested by stakeholders; studied areas related to PC included institutional and personal experience, training and education, and physician confidence. Data were summarized descriptively.

Results

Response rate was 28.7% (29/101). Most respondents were female (79.3%), Caucasian (48.3%), and practiced in an urban setting (85.2%). Only 1 fellow participated in a PC rotation during fellowship, and 46.4% of respondents completed a rotation in medical school or residency. On a scale of 1-5, with 1 being ‘no knowledge’ and 5 being ‘extensive knowledge’ of PC principles, fellows reported a mean knowledge of 2.33 ± 1.04. A single fellow had performed over 10 family meetings to elicit goals of care compared to 64.3% of fellows who had performed over 10 kidney biopsies. A quarter of fellows had never led such a meeting. Confidence in ability to discuss goals of care or address psychological distress in a child with CKD or parent were low, with only 30.8% and 26.9%, respectively, feeling moderately or very confident in their ability. Many fellows (44%) felt low confidence in managing pain in a child with CKD. A desire for additional training was prevalent, with 96.2% of fellows indicating that this training should happen during fellowship.

Conclusion

Few pediatric nephrology fellows receive PC education and experiences during training, resulting in low rates of knowledge and confidence across care domains. Fellows indicate a need and desire for improved PC training.

Funding

  • Other NIH Support