Symposia

Purpose: Communication between pediatric providers, patients, and their families is a key component of for children with serious illness, with broad implications for patient and family outcomes.Recommendations for effective and compassionate palliative communication in pediatrics are unique because of the 3-way relationship between providers, parents, and growing children, whose emerging autonomy requires special consideration.Memorial Sloan Kettering (MSK) has over 40 pediatric nurse practitioners (PNPs) providing primary oncologic care across outpatient and inpatient oncology settings.MSK's Comskil training program had a decade of experience training pediatric oncology MD fellows, but no program yet existed for the NPs so a needs assessment survey was conducted and a program was developed from 2012 to 2016.Methods: An anonymous, online survey was conducted of the MSK NPs (n = 42) that indicated high interest in training and low-overall confidence in particular targeted palliative care skills in pediatrics.A full training day including didactics, small group role play with feedback from expert facilitator, and peers was developed and conducted for all 42 NPs in 2013.A booster training was developed using novel role play methods to increase engagement, training relevance, and skills uptake based on course evaluations from this training.Results: Booster trainings have been recommended to improve uptake of skills through practice; however, little consensus exists on how and when to do boosters.On the basis of the theory of "active engagement," we designed boosters with custom role play scenarios based on PNP's clinical experiences, then used these in small group role play, after reviewing skills taught at the initial training.Standardized patient assessments, course evaluations and self-assessments pretraining, 2 weeks posttraining, and 6 months posttraining were conducted.Conclusions: Pediatric NPs working with children with serious illness benefit from palliative communication focused, pediatric-specific communication skills training.Nurse practitioner preferences, selfassessment, and skills' uptake outcomes will be discussed.