Pediatric palliative care subcompetencies for pediatric critical care medicine fellowship trainees

Authors

Kelly A. Lyons, Division of Pediatric Critical Care, Department of Pediatrics, University of Louisville School of Medicine, Norton Children's Hospital, Louisville, KY.
Rachel Ashworth, Division of Pediatric Critical Care and Palliative Care, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
Lauren Rissman, Advocate Health - MidwestFollow
Natalie Henderson, Division of Pediatric Critical Care, Department of Pediatrics, University of Louisville School of Medicine, Norton Children's Hospital, Louisville, KY.
Michael Certo, Division of Pediatric Palliative Care, Division of Pediatric Critical Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Kathyrn Palumbo, Department of Pediatrics, University of Rochester School of Medicine, Rochester, NY.
Mindy Dickerman, Department of Pediatrics, Nemours Children's Hospital, Wilmington, DE.
Moshe Cohn, Department of Palliative Medicine, Valley Health System, Teaneck, NJ.
Amanda Alladin, Division of Pediatric Critical Care, Department of Pediatrics, University of Miami Miller School of Medicine, Holtz Children's Hospital, Miami, FL.
Danielle DeCourcey, Division of Medical Critical Care, Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, MA.

Recommended Citation

Lyons KA, Ashworth R, Rissman L, et al. Pediatric Palliative Care Subcompetencies for Pediatric Critical Care Medicine Fellowship Trainees. Pediatr Crit Care Med. Published online June 16, 2025. doi:10.1097/PCC.0000000000003773

Affiliations

Advocate Children's Hospital Park Ridge

Abstract

Objectives:Integration of pediatric palliative care (PPC) and pediatric critical care medicine (PCCM) is essential in providing high-quality patient care. To date, no standardized or recommended framework for educating PCCM fellowship trainees in palliative care exists. We aimed to develop PPC subcompetencies for PCCM fellows within the constructs of the established Accreditation Council for Graduate Medical Education (ACGME) six core competencies.

Design and setting:An eight-member multicenter panel consisting of joint PPC and PCCM clinicians with expertise in fellow education curricula design used a modified Delphi method to construct subcompetencies for PPC within the ACGME core competency domains (patient care, medical knowledge, interpersonal/communication skills, professionalism, problem-based learning, and system-based practice). The process for development involved the following steps: 1) literature search, 2) evaluation of the ACGME program requirements for PPC and PCCM, 3) consensus meetings and evaluation to generate core knowledge, skills, and experiences needed using rating scales to sequentially prioritize curriculum content, and 4) selection and approval by multicenter team. Complete agreement was necessary for subcompetency inclusion.

Main results:Following the multi-step review process, 20 subcompetencies mapped to the core competency domains were included. A majority of subcompetencies were within the medical knowledge domain. Subcompetencies were further mapped to suggested entrustable professional activities and to specific recommended training years for subcompetency completion.

Conclusions:We present the first recommended PPC subcompetencies for PCCM fellows. Utilization of subcompetencies for fellow trainees is necessary to build primary palliative skills and improve confidence in delivering palliative care medicine within the pediatric critical care setting. Future efforts are needed to determine best practices for teaching and measuring competence. Recommended subcompetencies have the potential to standardize national PPC curricula for PCCM fellowship programs.

Type

Article

PubMed ID

40522004