Needs-Driven Simulation Education: Advancing Neuropalliative Communication for Neurology Residents

BackgroundPalliative care training in neurology residency is commonly limited, despite the fact that neurologists care for patients with complex palliative needs, such as high symptom burden, unique illness trajectories and prognoses (including prognostic uncertainty), and issues of decisional capacity.ObjectiveThe objective is to expand on neuropalliative curricula for neurology residents to improve delivery of palliative care to patients with neurological illness.MethodsWe developed an educational needs assessment to gather insight into the perceptions of palliative care topics, and confidence in providing palliative care, among adult neurology residents in 2020. The needs assessment guided the construction of a neuropalliative curriculum, including lecture materials and a simulation workshop focusing on provider communication skills, which was implemented in neurology training programs at two major academic medical centers between 2020 and 2024. Pre- and post-intervention surveys of self-reported comfort in different palliative care topics on a five-point Likert scale were analyzed with statistical testing to determine the effectiveness of the neuropalliative simulation curriculum.Results15 neurology trainees completed the needs assessment. For all palliative care topics, perceived importance was significantly higher than perceived confidence among trainees. After development and implementation of a novel neuropalliative curriculum, trainees reported improved comfort by an average of 0.6 points in all 6 domains between pre- (n = 58) and post- (n = 41) surveys.ConclusionsFormal, simulation-based neuropalliative curriculum is effective at improving self-reported comfort in providing primary palliative care among neurology trainees.