iPall: Learn Palliative Care
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Jennie Ottinger "It could be worse" 2012

Welcome to iPall: our Palliative Care learning community

Where you are visiting on your own or as part of a clinical rotation, we want to offer a warm welcome to the palliative care community.  This page serves as a starting point.  The rest of the pages have tremendous amount of material - but I marked key articles with asterisks to help prioritize the reading.

Overview

For those of you on a palliative care rotation, please think about what your goals might be, or what you'd like to focus on during the elective.  Skills you may wish to consider to focus on include:
  • Pain management (including prescribing opioids)
  • Other symptom management
  • Prognostication
  • Communication skills
  • Tending to family needs
  • Designing healthcare plan of care around a patient's goals (not merely of care, but general goals)
  • Finding and maintaining hope
  • Being with suffering
  • Humanism
  • Interdisciplinary teamwork
  • Learning about community resources, including hospice care

importance of reflection

Take time this month to reflect, not merely on the cognitive learning, but also on the heart of this experience.  Most of us come to healthcare to alleviate suffering, to find a way to lend strength, to support and care for another person.  This rotation and this field, perhaps more than most others, recognizes and values the importance of the time it takes to reflect on how these stories, these encounters change and teach us.  

I encourage you to use the Discussion forum Reflection section to share these thoughts (remembering to avoid using patient identifiers).

A few key articles (should look at before end of rotation)

  • Kelly, AS, Meier, DE Palliative Care — A Shifting Paradigm. N Engl J Med 2010; 363:781-782  (Open Access)
  • Cassel, EJ. The Nature of Suffering and the Goals of Medicine. N Engl J Med. 1982; 639-645. (Open Access)
  • Quill, TE. Initiating End-of-Life Discussions With Seriously Ill Patients: Addressing the “Elephant in the Room”. JAMA 2000; 284(19):2502-2507
  • Ferris, F. Last Hours of Living. Clin Geriatr Med 2004; 20: 641-667. (Open Access)
  • Gawande, A. . Letting Go: What should medicine do when it can’t save your life? The New Yorker. 2010, August 1 (Open Access)
  • Butler, K. . What Broke My Father’s Heart. The New York Times. 2010, June 1 (Open Access)
  • EPEC-Oncology - learning modules on palliative care (Free links)

Case Based Learning

"Our patients are our most important teachers," it is often said. Learning from them, from their experiences of illness, of decision-making, of their symptoms, and how they responded to the treatments we provide them will always be core to medical education, including palliative care.

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