Medical Students Build a 20-Minute Module to Fix a Gap in Pediatric End-of-Life Training

Talking with families about a child’s death is one of the hardest things any clinician will ever do, yet most medical students graduate having had almost no formal training in how to do it. A team of medical students at East Carolina University’s Brody School of Medicine set out to change that, designing and testing a compact, 20-minute virtual module on pediatric palliative care that could be delivered to learners early in their training. The project, described in a quasi-experimental study published in Discover Education, was conceived, produced, and narrated entirely by medical students, with guidance from an interdisciplinary group of faculty that included pediatric palliative care physicians, pediatric residents, and professors of bioethics.

The motivation for the initiative came from a well-documented hole in undergraduate medical education. The study’s authors note that exposure to pediatric palliative care in medical school is often limited to brief lessons within an ethics course or optional electives during residency, and resident physicians have reported feeling unprepared to hold end-of-life conversations with pediatric patients and their families as a result. By contrast, allied health fields such as nursing and psychology have made greater strides in standardizing pediatric palliative care topics within their curricula. The researchers attribute the shortfall in medical education to constraints on content, timing, and teaching medium, since medical schools must compress an enormous body of clinical knowledge and skill into a finite number of hours.

The module itself was built around Kolb’s Experiential Learning Cycle, a theoretical framework that emphasizes the value of real-world clinical vignettes and structured reflection for helping learners build experience and conceptualize future practice. Four medical students, spanning the first through third years and bringing interests in pediatrics, psychiatry, palliative care across the life continuum, and medical education, developed the content. Each had prior experience with palliative care, whether through personal lived experience, work as allied health professionals before medical school, or clinical rotations, and they received additional palliative care training from faculty before creating the module. The result was a student-produced, student-directed, and student-narrated video designed to remain concise, interactive, and clinically correlated.

Technically, the module was delivered online through Qualtrics survey software and distributed by mass email. Learners first provided written informed consent and demographic details, then completed a pre-survey assessing baseline knowledge of pediatric palliative care and subjective self-efficacy and comfort in interacting with this population. The 20-minute video that followed covered five core objectives: understanding the definitions of hospice, palliative, and end-of-life care; differentiating pediatric from adult palliative care; reviewing the indications for palliative care in pediatric populations; describing the needs of families of pediatric palliative care patients; and identifying additional resources for further training. Embedded questions, evidence-based figures, and graphics, along with publicly available and institutionally created videos of real clinical and community scenarios, provided active learning opportunities throughout.

The assessment instruments were carefully structured. Both the pre- and post-surveys consisted of 27 questions: the first nine addressed consent and demographics, seven were knowledge- and fact-based multiple-choice items, and the remaining 11 used Likert scales to capture personal reflection on confidence and comfort. Recruitment and module operation ran from April 1, 2024, to July 31, 2024, among first- to third-year medical students at a single, rural, MD-granting institution in a southern U.S. state that is missioned with producing primary care physicians for underserved and rural communities. The university’s Institutional Review Board determined the project met criteria for minimal-risk educational research and waived the requirement for formal approval.

Participation numbers tell a familiar story about learner bandwidth. Of 39 students recruited, 18 completed all study components, an attrition rate of roughly 46 percent that the authors attribute largely to the demanding lives and competing priorities of medical students. The 18 completers were a varied group: 44 percent reported prior healthcare experience, usually less than three years, while 56 percent reported none. Half reported no patient care experience at all, 44 percent had cared for one to five patients, and 28 percent had cared for six or more. More than half indicated prior exposure to palliative care in some form, ranging from professional experience caring for palliative patients to personal experience with family members receiving such care, and two students reported personal experience with serious illness among family or friends.

The quantitative results were sobering in one respect and encouraging in another. Mean knowledge scores rose slightly from 6.00 plus or minus 1.46 on the pretest to 6.17 plus or minus 1.42 on the posttest out of 7 possible points, a difference that was not statistically significant (t(17) = 0.90, p = 0.38). Because most participants scored between 5 and 7 points at baseline, the authors suggest a potential ceiling effect. In a subgroup analysis, the eight participants with prior palliative care exposure improved by a mean of 0.25 points, from a lower baseline, while the ten without prior exposure improved by only 0.10 points; neither change reached significance. Accuracy on individual topics was mixed, improving for questions on the physician’s role and the central tenets of pediatric palliative care, declining slightly for indications for palliative care, components of hospice care, and caregiver considerations, and holding steady for the scope of palliative care and its non-indications.

Where the objective scores plateaued, the subjective measures told a different story. Approximately 90 percent of participants selected

Subject of Research: Implementation of a medical student led pediatric palliative care module

Article Title: Implementation of a medical student led pediatric palliative care module

Article References: Denning, M., Umozurike, G., Khanchandani, A., & Larkins, M. C. (2026). Implementation of a medical student led pediatric palliative care module. Discover Education, 5(1), Article 1178. https://doi.org/10.1007/s44217-026-02091-8

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02091-8

Keywords: Implementation, medical, student, pediatric, palliative, care, module, scientific research