iPall: Learn Palliative Care
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Palliative Care Rotation

Course Description:  The elective provides medical students, residents and fellows with knowledge, attitudes and skills fundamental to the care of seriously ill patients and their families. 

By the end of the month, a visiting resident, student or fellow will:
  • know how to assess and manage pain (perform thorough pain assessment, understand pain management through medication and non-drug interventions)
  • know how to assess and manage non-pain symptoms, including nausea, constipation, dyspnea and delirium
  • use performance scales and other factors to assess prognosis
  • know how to care for the imminently dying patient
  • demonstrate communications skills in breaking bad news, goal setting, advance directives, decision-making capacity and hospice referral
  • understand Medicare hospice eligibility, covered services, team model and sites of care
  • know the differences and similarities between hospice and palliative care
  • identify ethical/legal distinctions between withdrawal of life-sustaining medical care (including artificial nutrition and hydration), palliative sedation, assisted suicide and euthanasia
  • understand the physician’s professional responsibility in shared decision-making
  • find evidence-based resources for palliative care relevant to patient encounters
  • recognize differences between sadness, clinical depression, anticipatory grief, normal grief and complicated grief
  • gain proficiency in caring for patients and families from different cultures, religious traditions, and primary language
  • articulate her/his own personal values and emotional reactions, and their impact on patient care and self-care.

Learners achieve these goals by:
  • participating in the care of palliative care/hospice patients and families
  • observing and working with the interdisciplinary team
  • performing a thorough biopsychosocial assessment of at least one patient, and presenting her/him to the interdisciplinary team
  • attending didactics and debriefings with palliative care/hospice faculty
  • researching and presenting a topic of interest in palliative care to interdisciplinary team
  • independent studying, with materials provided by faculty
  • spending time with patients/families to listen to their stories and be present with their suffering
  • participating on conferences/discussion forums and through reflective blog submissions in the affiliated online group
  • reflecting on their own emotions, self-care and professionalism by writing (examples: personal journal, “parallel chart,” blog on LGLC)
  • completing a take-home test by the end of the rotation.

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