Paediatric Palliative Care at Asia Pacific Hospice Conference in Incheon, Korea

The 15th edition of the Asia Pacific Hospice Conference (4-7 Oct 2023) came to a glorious close early this month. The biennial event that tours different member countries is a highlight for all palliative care practitioners in the region. This round, proceedings were held at the massive and modern Songdo Convention Centre in Incheon, Korea. The event was jointly organised by the Asia Pacific Hospice and Palliative Care Network (APHN) in collaboration with local representatives in Korea. With rich and eclectic plenaries and talks delivered by invited international experts, regional scholars and expert clinicians, participants that numbered more than a thousand returned home satiated with new knowledge and skills.

The Special Interest Group (SIG) in APHN that I co-chair with Dr Nobuyuki Yotani from Japan started preparatory work two years back to assemble a coherent programme for paediatric practitioners alongside the adult tracks throughout the four-day event. Eventually, we delivered an EPEC preconference on the 4th Oct, followed by offerings devoted to paediatric topics every day throughout the main conference. In fact, we were given one full slot to do a series of three paediatric palliative care (PPC) talks on the second day and we had a blast! More about that later.

After a successful run of EPEC Paediatrics in Manila, Philippines in March this year, it was full steam ahead in the next months to plan the next one in Korea. We received guidance and support from Dr Ross Drake at Starship Children Hospital in Auckland, New Zealand. He was the pioneer that brought the validated and much-feted EPEC programme from North America to the Asia Pacific back in 2016. With preliminary understanding of practice development in Korea to date, the SIG decided to run an end-user workshop rather than a Train-the-Trainer conference this time. Many similar decisions as well as content curation were facilitated by two wonderful colleagues – Dr Min Sun Kim and Dr In Gyu Song – from Seoul, Korea who co-designed the entire programme with us. The lovely husband-and-wife team had previously attended Professional Development Workshops in the stepwise EPEC-Paediatrics package to become master facilitators. On top of our esteemed Korean colleagues, the carefully selected faculty of six included Dr Ross Drake himself, Dr Gemma Aburn (New Zealand), Dr Marta Salek (USA) and myself (Singapore). Despite having prior experience elsewhere, lots were learnt in the process of rendering the workshop in Korea, particularly in the setting of foreign language, diverse cultures and practice like the Asia Pacific. Many obstacles notwithstanding, as a faculty, we worked seamlessly.

Two thirds of our workshop participants were Korean and spoke minimal English. We decided to spare significant expense to hire two interpreters for the day to do translations between Korean and English. Min Sun and In Gyu delivered their talks in Korean while the rest of the faculty presented in English. With PowerPoint decks translated beforehand, the Korean participants followed our talks on headsets with simultaneous interpretation. To meet the needs of more experienced clinicians, we divided the large group of participants into two during communication skill training – the developing group (majority) and deepening group (a dozen clinicians). The former practiced using the SPIKE framework while the latter conducted role plays that focused on sharpening techniques around conducting an advance care planning discussion. The rest of the day, everyone came together to hear talks from the faculty on pain and breathlessness management, neonatal palliative care, end-of-life care and finally, self-care. The day went smoothly, and quickly too.

In all, we had 62 participants from 10 countries that registered. We were delighted to see many nurses, social workers and other allied health professionals in the audience. This is uncommon in the past. Active efforts were made to whip up the atmosphere in the room as we were warned that the Koreans are a quiet lot. In the end, the interdisciplinary networking and exchange that trumped language barriers was a delightful surprise. Once we got used to the technology, the translators literally bridged the gaps and connected the hearts!



Participants had these to share:

What did you most enjoy? The efforts and enthusiasm of the facilitators in imparting to us their knowledge and experiences in pediatric palliative care. (participant 1)

Any other feedback? I really wish to participate in more EPEC workshops or the advanced level of EPEC. And please come back to Korea! (participant 2)

During the main conference, we presented topics on education and research in PPC; ethical issues in neonatal palliative care; family-centred communication; and caring for seriously ill children at home. The highlight of the day was a ‘dangerous’ experiment to trial a different mode of presentation on the topic of paediatric pain management called “The Squid Game”. Min Sun and I introduced two cases (one oncology and the other non-oncology, based on real life cases encountered in Seoul) for two experts (Marta and Ross) to ‘battle it out’, offering practical tips in the approach to pain assessment and management in complex pain situations. Nobody died in the end (phew!) but everyone went away with deeper appreciation of the nuanced approach to paediatric pain management, utilizing compassionate and holistic care that is founded on clinical wisdom.

With countless happy and unforgettable moments during this very short tour, the group has already firmed plans to return to Korea. An EPEC Train the Trainer conference and possibly a Professional Development Workshop are planned. Watch this space!

Participants at the APHN Conference 2023

Participants at the APHN Conference 2023