Education Research: Neuropalliative Care Education: A National Survey of Neurology Program and Fellowship Directors.

Background and Objectives: Patients with neurologic disease have a variety of unmet palliative care needs. Both the Accreditation Council for Graduate Medical Education and Academy of Neurology have emphasized the need for neuropalliative care education in recent years. Neurology training programs have widely variable practices in teaching neuropalliative care. This study aims to characterize current practices in providing neuropalliative care education across graduate neurology training and to identify barriers to its delivery. Methods: We surveyed program directors (PDs) of neurology residency and fellowship training programs in the United States regarding their current methods of teaching neuropalliative care topics, perceived importance of these topics, relevant subspecialty resources, and perceived barriers to providing neuropalliative care education. Results: Our survey was emailed to 777 PDs and fellowship directors. In total, 118 responses were included in the analytic sample (response rate 15.2%). Program directors generally perceived neuropalliative care education as important, with a median rank of 7 of 10. 91% of adult neurology residency programs and 66% of fellowship programs included palliative care topics in their didactics curricula. Topics emphasized varied depending on the training program's subspecialty. Respondents highlighted barriers to implementing neuropalliative care training, including inadequate trainee and faculty time and lack of adequate teaching faculty. Discussion: Neurology training programs continue to exhibit considerable variability in palliative care education curricula. Although most programs reported a presence of palliative care in their institutions, variability exists in the amount of palliative care education taught, the topics emphasized, and the teaching methods. Notably, there is an opportunity for fellowship programs to increase the amount of neuropalliative care topics taught in their curricula. Neurology residency and fellowship directors may benefit from using existing neuropalliative care curricula to enhance this area of education, partnering with local non-neurology faculty to teach palliative topics, and integrating palliative care topics into subspecialty training.