Identifying Palliative Care Competencies for Cardiology Fellowship Training

BACKGROUND: There is growing evidence of the benefits of palliative care (PC) for patients with complex cardiovascular disease (CVD), and it is recommended alongside routine management. Cardiovascular clinicians must be equipped to address basic PC needs to meet the increasing demands of an aging population. However, many feel unprepared due to the limited education they received during their training. OBJECTIVES: The goal was to use expert opinion to develop a core set of PC competencies for cardiovascular medicine trainees. METHODS: A modified Delphi study design was used to reach consensus among experts in CVD, PC, and medical education. A list of 35 potential PC competencies was developed into a survey, in which content experts rated the competencies using a 5-point Likert scale. A threshold for consensus was established a priori at >75% for each round, and 3 Delphi rounds were completed. RESULTS: Of the 120 experts identified, 36 (30%) initially consented to participate, 31 responded to the first and second rounds, and 28 responded to the third round. By the end of round 2, 28 (82%) competencies had reached consensus and 8 competencies reached >95% consensus. In round 3, 14 (50%) competencies were deemed "core" and 14 (50%) were "desirable." CONCLUSIONS: This Delphi study achieved consensus on 14 core PC skills that CVD fellows should master by the end of their training. There is an opportunity to include these competencies in formal expectations for cardiology fellowship training programs, which may contribute to the delivery of high-quality, patient-centered cardiovascular care.