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:
Learners achieve these goals by:
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.