“I Learned That No Death Is Routine”

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Abstract
The American Academy of Pediatrics' statement on palliative care for children emphasizes the need to identify and address barriers to effective palliative care. The authors describe a seminar for pediatrics residents on death and bereavement that addresses these issues. The day-long seminar for second-year residents has been offered annually since 1996. The seminar is conducted offsite so that residents can concentrate without distraction. The seminar uses an intense and comprehensive multidisciplinary approach to accomplish seven goals: (1) to have residents gain expertise in talking with parents about the death of their child; (2) to have residents practice and experience how it feels to be in emotionally charged situations; (3) to train residents to become more knowledgeable concerning autopsy and organ donation, and to learn strategies to approach these topics with a child's parents; (4) to have residents gain an understanding of the role of the ministry for families who are grieving; (5) to provide residents with multidisciplinary strategies to support a family after a child has died; (6) to help residents gain insight into the impact of death on their own emotions and the importance of addressing their own emotions to cope with stress and potential burnout; (7) and to help residents better understand the parents' perceptions of the medical care providers and their dying child. In their evaluation comments, the residents report value from a seminar designed to help them address issues of patient death and bereavement. This type of educational intervention should be considered for the curriculum by other residency programs.