Table 1.

Pediatric Palliative Care- Problem-Based Learning the Case of JM: Presentation and Topics for Discussion

The case of JM	Sample topics of discussion
Part 1 Continuing from the previous PBL case discussion in which a four-year-old female child (JM) is newly diagnosed with acute myeloid leukemia (AML), we “fast forward” and describe the same child now as follows: JM is now 18 weeks from initial diagnosis and has completed three different regimens of chemotherapy. However, bone marrow aspiration shows that the AML persists. Her pain is escalating. No available bone marrow donor was identified and no further cure-directed therapies are available. A family meeting is scheduled.	(1) What is the differential diagnosis of JM's pain now? (2) What do you want to know to help you manage her pain and suffering? (3) What aspects of the patient's psychosocial history do you want to know and why? (4) What are your goals and expectations for the family meeting with JM and her family? (5) Who else from the healthcare team needs to be involved in the care of this patient?
Between Parts 1 and 2, students assign themselves to research-relevant issues to this patients' care plan and prepare to discuss them in the next session (e.g., pain management, psychosocial issues, legal/ethical concerns, and family values/goals of care, experimental therapies, advance directives, and hospice and home care).
Part 2 Students present their findings and collaborate to develop a comprehensive palliative care plan for JM incorporating their research. Time for reflection about this case is also encouraged	(1) What are the treatment options for JM? (2) What is the next step in caring for JM? (i.e., home, hospice, and hospital). If JM wants to go home, what will she need at home? (3) How can your communication style help provide support to the family?

PBL, problem-based learning.