RPD300 - Educational Case Study of Reflective Learning in Neuropalliative Education

Key Message : Strategically applied learning theory can expand the number available instructors for palliative education across medical specialties. This case study highlights how reflective learning, facilitated by teachers across disciplines, can improve knowledge, skills, and attitudes around core palliative concepts applied to clinical neurology.

Abstract:

Background: Palliative medicine is defined by the ACGME as a core competency in neurology residency training (1), yet program directors and trainees describe limited access due to few neuropalliative content experts (2,3). We hypothesize that structured reflective learning (4) can expand palliative teaching capacity by recruiting facilitators across disciplines to meet this documented need for specialty specific palliative education.

Objectives: The primary objective was to design a session grounded in reflective learning that effectively introduces neuropalliative concepts to neurology trainees. Secondary objectives included measuring learner confidence in advance care planning (ACP) and describing learner and facilitator perspectives on feasibility and impact.

Methods: We employed a case study design with mixed methods data collection. The workshop was embedded in the ambulatory didactic curriculum for one neurology residency. Sessions were co-facilitated by a licensed clinical social worker, a geripalliative physician, and a neuropalliative physician. Learners completed pre- and post-session surveys assessing confidence in ACP skills (Likert scale), engagement, and perceived impact. Thematic analysis of open-ended responses complemented quantitative findings.

Results: Across three years (2023–2025), 127 residents participated in the ambulatory didactic, with 60% completing pre-session and 48% post-session surveys. Confidence in ACP discussions increased significantly (mean 5.6 ± 1.68 to 7.03 ± 1.22, p< 0.001). Over 98% of respondents reported practice-changing takeaways and relevance to clinical care. Qualitative themes highlighted the workshop as engaging, safe, and uniquely impactful, with facilitators noting reciprocal learning.

Conclusions: Reflective learning is a feasible and effective strategy for neuropalliative education. Facilitators from multiple disciplines can successfully teach core skills through structured reflective learning, broadening the instructor pool. This model demonstrates strong learner satisfaction and measurable gains in ACP confidence. Future directions include direct clinical observation to measure learned skills and applying this teaching framework to unique neurologic illnesses and settings.

References: 1. ACGME. ACGME Program Requirements for Graduate Medical Education in Neurology.
2. Mehta AK, Najjar S, May N, Shah B, Blackhall L. A Needs Assessment of Palliative Care Education among the United States Adult Neurology Residency Programs. Journal of Palliative Medicine. 2018;21(10):1448-1457
3. Goyal T, Hasty BN, Merrell SB, Gold CA. Education Research: Understanding barriers to goals of care communication for neurology trainees. Neurology. 2019;93(8):362-366
4. Kaufman DM. Teaching and Learning in Medical Education. In: Understanding Medical Education. John Wiley & Sons, Ltd; 2018:37-69