ABSTRACT #24

ASSESSING THE EFFECTIVENESS OF A STANDARDIZED AND CONCISE END-OF-LIFE (EOL) CARE TOOLKIT FOR MEDICAL RESIDENTS IN A TEACHING HOSPITAL: A MIXED METHODS EXPLORATORY STUDY

Yu Shindo, Noelle Javier, Aveena Kochar

PURPOSE AND GOALS: With palliative care gaining traction as a vital specialty to help patients living with serious illnesses comes the need for further training of healthcare professionals. Frontline providers such as medical residents can benefit from end-of-life (EOL) care training in symptom management.

METHODS: There are three phases (over a period of 4 years) to this study, namely: administration of a needs assessment survey of baseline knowledge, attitudes, and practices on EOL non-pain symptom management; development and implementation of a standardized inpatient EOL symptom management toolkit.

EVALUATION PLAN: After implementing a standardized inpatient EOL symptom management toolkit, we compared pre- and post-assessment after the educational intervention.

SUMMARY OF RESULTS: The baseline survey had 66 participants. There were six non-pain symptoms that were elicited as important for further education and training. These were anorexia, nausea/vomiting, dyspnea, oral secretions, myoclonus, and delirium. Competency-based comfort and confidence levels were assessed using a Likert scale (1 to 5), with the highest number as the most comfortable. The residents were noted to be more comfortable with EOL communication than symptom management. Furthermore, residents who had had previous EOL care experiences with patients were more comfortable in symptom management. The educational intervention implemented at a later time revealed that there was an improvement in post-test scores for EOL symptom management.

REFLECTIVE CRITIQUE: This study highlights the needs and gaps in EOL symptom management training for medical residents. Implementing a standardized inpatient EOL symptom management toolkit might serve as a potential intervention to address the needs and narrow gaps in medical training. This can serve as a possible template for other institutions to integrate an EOL care curriculum in medical residency. Limitations of the study include small sample size, implementation during the COVID-19 pandemic, variable participant response rate, and interrupted timelines.

The following steps include ongoing resident training, long-term follow-up post-intervention, and institutional buy-in.