Terminal
Objective I. ANALYZE
the value of palliative/hospice care as a component of practice in managing
specific patient problems.
|
ENABLING OBJECTIVES
for Terminal Objective I |
Teaching
Strategy |
Evaluation |
|
I
A. State
the definition of palliative care (Freshman level). |
Didactic/discussion,
small group sessions in ICP* course Freshman year |
Small
group leader evaluation; ICP course final exam |
|
I
B. Summarize
the mission, definition, and philosophy of hospice (Freshman level). |
Didactic/discussion,
small group sessions in ICP* course Freshman year |
Small
group leader evaluation; ICP course final exam |
|
I
C. State
the elements of hospice care and the hospice definition of the unit of
care (Freshman level). |
Didactic/discussion,
small group sessions in ICP* course Freshman year |
Small
group leader evaluation; ICP course final exam |
|
I
D. Describe
the impact of the culture of medicine on the practice of
palliative/hospice care (Freshman level). |
Didactic/discussion,
small group sessions in ICP* course Freshman year |
Small
group leader evaluation; ICP course final exam |
|
I
E. State
the reasons supporting the argument that, when appropriate,
palliative/hospice care is a desirable and important service (Freshman
level). |
Didactic/discussion,
small group sessions in ICP* course Freshman year |
Small
group leader evaluation; ICP course final exam |
|
I
F. Identify
one's own views of palliative/hospice care. (Freshman & Junior level). |
Didactic/discussion,
small group sessions in ICP* course Freshman year, participation in junior
Hospice rotation |
Small
group leader evaluation; ICP course final exam, Written essay junior year |
|
I
G. State
the personally rewarding aspects of palliative/ hospice care mentioned
by palliative/hospice care professionals (Freshman level). |
Didactic/discussion,
small group sessions in ICP* course Freshman year |
Small
group leader evaluation; ICP course final exam |
|
I
H. Examine reasons supporting the argument that the primary care
physician has an important role in the care of a patient with a terminal
illness (Junior level). |
Entire
Junior rotation in palliative medicine and hospice |
Discussion
of topic in simulated IDT* meeting; Written exam |
Terminal
Objective II. DEMONSTRATE
a compassionate approach to the care of patients with terminal illness
|
ENABLING OBJECTIVES
for Terminal Objective II |
Teaching
Strategy |
Evaluation |
|
II
A. Recognize
the difference between compassionate and dispassionate approaches in the
care of terminally ill patients (Freshman level). |
Didactic/discussion,
small group sessions in ICP course Freshman year |
Small
group leader evaluation; ICP course final exam |
|
II
B. Discuss
the use of the various levels of the Biopsychosocial Model and the complex
nature of terminal illness (Freshman and Junior level). |
Didactic
and small group learning session 1 Junior rotation, Discussion in IDT
meeting |
Objective
examination, observation with patients and in patient presentation |
|
II
C. Describe
the essential elements of compassionate care (Freshman level). |
Didactic/discussion,
small group sessions in ICP course Freshman year |
Small
group leader evaluation; ICP course final exam |
|
II
D. Recognize
behaviors indicative of dispassionate approach to care (Freshman level). |
Didactic/discussion,
small group sessions in ICP course Freshman year |
Small
group leader evaluation; ICP course final exam |
|
II
E. Recognize
the difference between the needs of the physician and those of a
terminally ill patient and patient's family system (Freshman level). |
Didactic/discussion,
small group sessions in ICP course Freshman year |
Small
group leader evaluation; ICP course final exam |
|
II
F. Explain
how a physician's feelings and attitudes toward terminally ill patients
can affect their abilities to communicate effectively with such patients
and their family systems (Freshman). |
Didactic/discussion,
small group sessions in ICP course Freshman year |
Small
group leader evaluation; ICP course final exam |
|
II
G. Discuss
the complex nature of terminal illness (Freshman & Junior level). |
Didactic
session; role playing exercises; Patient interviews; |
Written
exam; observation of student in IDT |
|
II
H. Discuss
the need for sensitivity to the fears and concerns of a terminally ill
patient (Junior level). |
Didactic
session; role playing exercises; Patient interviews; |
Written
exam; observation of student in IDT |
|
II
I.
Identify cognitive and affective reactions of a terminally ill patient or
the members of the patient's family (Junior level). |
Didactic
session; role playing exercises; Patient interviews; |
Written
exam; observation of student in IDT |
|
II
J. Perform a psychosocial assessment applying principles of
compassionate care (Junior level). |
Didactic
session; role playing exercises; Patient interviews; |
Written
exam; observation of student in IDT |
|
II
K. Discuss spirituality as it applies to a person with a terminal illness
(Junior level). |
Didactic
session; Patient interviews |
Written
exam; observation of student in IDT |
|
II
L. Discuss the spiritual needs of a patient with a terminal illness
(Junior level). |
Didactic
session; Patient interviews |
Written
exam; observation of student in IDT |
|
II
M. Discuss the unique contributions of hospice care in meeting spiritual
needs of the patient and family (Junior level). |
Didactic
session; out-of-classroom study of selected references |
Written
exam |
|
II
N. Analyze one's own emotional and cognitive reactions during an interview
with a terminally ill patient (Junior level). |
Patient
interviews; role playing |
Required
Essay |
|
II
O. Describe several supportive measures to use with patients and families
during the end-of-life period (Junior level). |
Role
playing; case analysis; readings |
Written
exam; observation of student in IDT |
|
II
P. Discuss how a physician can provide emotional support and psychological
comfort to a terminally ill patient or a member of the patient's family
system (Junior level). |
Didactic; Patient
interviews |
Written
exam; Observation of student during patient interviews |
Terminal
Objective III.
DESIGN, in
cooperation with the interdisciplinary hospice/palliative care team, a
comprehensive plan of care for a patient with a terminal illness
|
ENABLING OBJECTIVES
for Terminal Objective III |
Teaching
Strategy |
Evaluation |
|
III
A. Explain how to help a patient and family system understand the
diagnosis of a terminal illness (Junior level). |
Didactic
session; role playing; patient interviews |
Faculty
observation of role play; written exam |
|
III
B. Discuss the physician's role in empowering terminally ill patients to
implement their decisions (Junior level). |
Didactic
session |
Written exam; Observation of performance in IDT meeting |
|
III
C. Describe/Clarify the essential information needed by patients and
families in their consideration to use Hospice Care (Junior level). |
Didactic
session |
Written
exam; Observation of performance in IDT meeting |
|
III
D. Describe how a terminal illness can affect the family group (Junior
level). |
Didactic
session; assigned reading; patient interviews |
Written
exam; Observation of performance in IDT meeting |
|
III
E. Identify the common emotional and practical needs of hospice patients
in finishing their life business (Junior level). |
Didactic
session; assigned reading; chart review; patient interviews |
Written
exam; observation of performance in IDT meeting |
|
III
F. Determine the best setting and time for providing palliative/hospice
care to a patient with terminal illness (Junior level). |
Patient
interviews; Didactic session; reading assignments |
observation
of performance in IDT meeting |
|
III
G. Differentiate the decision-making process in palliative vs. curative
care (Junior level). |
Didactic
session; assigned reading; chart review; patient interviews |
Written
exam; observation of performance in IDT meeting |
|
III
H. Discuss the ethical and legal dilemmas in providing hospice care
(Junior level). |
Didactic
session by Dr. Keay during Junior rotation in Family Medicine; patient
interviews |
Test
questions, student presentations |
|
III
I. Explain how insurance reimbursement policies define and drive hospice
care (Junior level). |
Didactic
session |
Written
exam |
|
III
J. Describe the role of each member of the hospice Interdisciplinary Team
(IDT), including the role of the physician (Junior level). |
Didactic
session; Participation in IDT meeting |
Written
exam; observation of performance in IDT meeting |
|
III
K Conduct a comprehensive assessment of the distressing symptoms
associated with a terminally ill patient (Junior level). |
chart
review; patient interviews |
observation
of performance in IDT meeting |
|
III
L. Identify the pharmacological and non-pharmacological approaches to
treating the distressing symptoms associated with a terminal illness
(Junior level). |
Didactic
session; chart review; patient interviews; programs of self-study |
Written
exam; observation of performance in IDT meeting |
|
III
M. Discuss the complexities of pain management and its relationship to a
patient's perceived quality of life (Junior level). |
Didactic
session; assigned reading; chart review; patient interviews |
Written
exam; observation of performance in IDT meeting |
|
III
N. Collaborate with members of the hospice IDT
(Junior level). |
Role
playing |
IDT
participation |
|
III
O. Develop a plan of care aimed at controlling the distressing symptoms of
a patient with terminal illness (Junior level). |
chart
review; patient interviews |
Student
presentation in simulated IDT meeting |
|
III
P. Determine the impact of the treatment regimen for a terminal illness on
the patient and family system (Junior level). |
patient
interviews; chart review |
observation
of performance in IDT meeting |
* Abbreviations used are: ICP = Introduction to Clinical Practice course; IDT = interdisciplinary team.