End-of-life care curriculum for medical teachers

[NRSKarenRN, BSN, RN]

Stanford Faculty Deveolpment Denter @ Growthhouse.org

End-of-life care curriculum for medical teachers

Until recently, end-of-life care (ELC) has been neglected in physician training. A number of studies show serious deficiencies in end-of-life care, both in the U.S. and in other countries. This has resulted in bad dying experiences for patients, their families, physicians and other health care workers. With support from the Robert Wood Johnson Foundation, The Stanford Faculty Development Center (SFDC) developed a 16-hour faculty development course incorporating basic material designed to be used by physicians in any area of expertise. This web-based curriculum is an adaptation of materials developed for that course.

The overall goals of the End-of-Life Care Curriculum for Medical Teachers are to enhance physician skills in ELC, foster a commitment to improving care for the dying, improve the dying experience for patients, families, and health care providers, and improve teaching related to ELC.

Originally each topic was designed to be covered in a two-hour interactive and didactic seminar. You may wish to teach only portions of a seminar or to use parts of the material in different combinations. Please familiarize yourself with the section "How to use this curriculum" in the Teacher's Handbook to help you make the most of the instructional methods for potential challenges in teaching that particular segment of the material.

The web version also includes links to relevant portions of the online version of the companion book, "Palliative Care Perspectives," by James Hallenbeck, MD. The book text provides an additional level of detail that complements the higher-level teaching points included in the PowerPoint slides.

Teacher's Handbook for the curriculum includes guidance for each module:

1. Overview: Death and Dying in the U.S.A.
   
2. Pain Management
   
3. Communicating with Patients and Families
   
4. Making Difficult Decisions
   
5. Non-Pain Symptom Management
   
6. Venues and Systems of Care
   
7. Psychiatric Issues and Spirituality
   
8. Instituting Change
   

Especially see sections:

2. pain management

after a consideration of barriers to care, provides a pain assessment tool, and discusses non-pharmacologic and pharmacologic interventions, including opioids and the process of opioid conversion and adjustment.

html | powerpoint (188 kb)

5. non-pain symptom management

offers a frame shift for thinking about symptoms, provides an analytic tool for identifying appropriate therapies, and uses this tool to address nausea and vomiting, dyspnea, terminal syndrome characterized by respiratory secretions, and cachexia, anorexia, and asthenia.

html | powerpoint (142 kb)