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Pediatric Palliative and End of Life Care

The Pediatric Palliative Care program is designed to provide information to practitioners who treat pediatric patients in the primary care or the subspecialty setting about palliative care for pediatric patients. The course content covers palliative care delivery by designated palliative care teams, primary palliative care, end of life symptom treatment and orders for life sustaining therapies.

This is a self-paced, open-enrollment course that may be started and completed at any time. Please note: This course requires an updated browser to function properly. Requires Safari (v6 or higher), Chrome (v38 or higher), Internet Explorer (v11 or higher), or Firefox (v23 or higher). To check your current browser version, click here.

About This Course

The Pediatric Palliative Care program is designed to provide information to practitioners who treat pediatric patients in the primary care or the subspecialty setting about palliative care for pediatric patients. The course content covers palliative care delivery by designated palliative care teams, primary palliative care, end of life symptom treatment and orders for life sustaining therapies.

This course was developed by the OPENPediatrics program at Boston Children's Hospital, and provides Continuing Medical Education credit. To access a free, non-CME version of this course, as well as hundreds of other free resources on pediatric care, visit the OPENPediatrics site.

Cost

USD $75.00

Contributors

David Casavant, MD, Richard Goldstein, MD, Emma Jones, MD, Joanne Wolfe, MD, MPH, Amy Sanderson, MD, Shari Nethersole, MD

Instructional Time

3 hours

Course Format, Media and Technical Requirements

Self-paced, using text and video, with post-test assessments. Requires 80% or higher score to earn CME credit. Online course assessment. Requires Safari (v6 or higher), Chrome (v38 or higher), Internet Explorer (v11 or higher), or Firefox (v23 or higher).

Release/Review/Expiration Dates

Released: 09/08/2016

Reviewed: 09/08/2016

Expires: 09/08/2017

Learning Objectives

  • Describe the differences between primary and subspecialty palliative care and how they complement one another
  • Describe the potential limitations of end-of-life decisions
  • Review how to identify patient wishes related to comfort, support, and remembrance at the end-of-life by family and friends
  • Identify routine health care interactions as an opportunity for long-term goals discussion
  • Clarify the family’s understanding of the patient’s illness, identify worries and fears and discuss trade-offs between clinical choices including conditions that would be desirable or unacceptable
  • Conduct a complete pain assessment appropriate for the age of the child
  • Describe the neurobiological mechanisms of normal pain perception
  • Describe the clinical implications of the neurobiological mechanisms of pain perception for treating and preventing pain
  • Design a pain treatment strategy for a child at the end-of-life
  • Describe the different palliative care outcomes
  • Identify concerns regarding current state of advance care planning (ACP) for children with life-threatening diseases
  • Describe the barriers to the use of MOLST

Statement of Need/Target Audience

There is a large amount of research about end-of-life and palliative care for pediatric patients, the vast majority of which supports the need for increased education and training. Resident physicians surveyed had little comfort with palliative care for children and wished they coud receive more training in pain control, disclosing bad news, code status decision-making and end-of-life care with pediatric patients. In another study, staff members and families of patients who were deceased were surveyed about the delivery of pediatric palliative care in a hospital considering development of a palliative care team. Approximately 450 staff members (including nurses, social workers, attending and resident physicians) felt inexperienced discussing end-of-life issues, transition to palliative care and limiting resuscitation. Sixty-eight family members of deceased patients reported distress around the "uncaring" delivery of bad news and poor pain management. The results of these two surveys are representative of published literature on the topic of pediatric end-of-life and palliative care and thus support the need for our effort to provide more education on these topics.

1. Kolarik RC, Walker G, Arnold RM. Pediatric resident education in palliative care: A needs assessment. Pediatrics 2006;117:1949-54.

2. Contro NA, Larson J, Scofield S, Sourkes B, Cohen HJ. Hospital staff and family perspectives regarding quality of pediatric palliative care. Pediatrics 2004;114:1248-52.

  • MDs and Trainees
  • Pediatric MDs and Trainees
  • Pediatric Intensive Care (ICU) MDs and Trainees
  • Accreditation/Designation Statements

    Boston Children's Hospital is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Boston Children's Hospital designates this enduring material for a maximum of 3.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Pediatric Palliative and End of Life Care meets the requirement for 3.0 Risk Management Credits proscribed by the Massachusetts Board of Registration in Medicine and defined in 243 CMR 2.06(5)(d) I.

    Through an agreement between the American Medical Association and the European Union of Medical Specialists, physicians may convert AMA PRA Category 1 Credit™ to an equivalent number of European CME Credits® (ECMECs®). Information on the process of converting AMA PRA Category 1 Credits™ to ECMECs® can be found at: www.eaccme.eu.

    Instructors

    Dr. David Casavant, MD

    Associate in Perioperative Anesthesia, Pain Medicine and Critical Care Medicine, Boston Children's Hospital
    Instructor of Anesthesia, Harvard Medical School

    Dr. Richard Goldstein, MD

    Progam Director, Robert's Program on Sudden Unexpected Death in Pediatrics; Attending Physician, Pediatric Advanced Care Team (PACT); Assistant Professor of Pediatrics, Harvard Medical School

    Dr. Emma Jones, MD

    Attending Physician, Pediatric Advanced Care Team (PACT); Instructor in Medicine, Harvard Medical School

    Dr. Amy Sanderson, MD

    Assistant in Critical Care Medicine; Instructor in Anesthesia, Harvard Medical School

    Dr. Joanne Wolfe, MD, MPH

    Director, Pediatric Palliative Care at Boston Children's Hospital and Dana-Farber; Division Chief, Pediatric Palliative Care Service, Department of Psychosocial Oncology and Palliative Care, Dana-Farber; Associate Professor of Pediatrics

    Dr. Shari Nethersole, MD

    Assistant in Medicine, Children's Hospital Primary Care Center; Assistant Professor of Pediatrics, Harvard Medical School

    Disclosures

    In accordance with the disclosure policy of Boston Children's Hospital and the standards set forth by the Accreditation Council for Continuing Medical Education, course planners, speakers and content reviewers list below any relevant relationships they or their spouse/partner have to companies producing, marketing, re-selling or distributing health care goods or services consumed by or used on patients.

    Instructor Disclosures

    No disclosures to report:

    Dr. David Casavant, Dr. Richard Goldstein, Dr. Emma Jones, Dr. Amy Sanderson, Dr. Joanne Wolfe, Dr. Shari Nethersole

    Content Reviewers

    No disclosures to report:

    Lesley Niccolini

    Commercial and Financial Support Disclosure

    This program receives no commercial support.

    Privacy Policy

    Access the Boston Children's Hospital CME Privacy Policy here.

    1. Course Number

      BCH.AN003-OP
    2. Classes Start

      Jan 17, 2017
    3. Classes End

      Sep 08, 2017
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