 LINKS TO NCI |
R25
Cancer Education Grant Program; Instructional Design of Palliative Care Educational Program |
Return to Junior Hospice Module Home Page
LINKS TO NCI |
R25
Cancer Education Grant Program; Instructional Design of Palliative Care Educational Program |
Description of R25 Grants Program: http://cancertraining.nci.nih.gov/cancerEd/cancered.html
NCI Request for
Applications (RFA) on Palliative Care Education Programs (excerpted from RFA
CA-94-012, issued April 1, 1994):
"PURPOSE: The
National Cancer Institute (NCI) invites grant applications to create new
educational programs to address health professional training in palliative
patient care. The intent of this RFA is to emphasize NCI's concern for this
neglected area with the expectation that any funded programs will act as
catalysts to encourage further interest and development in the medical
community.
"BACKGROUND AND RESEARCH OBJECTIVES: There are
few formally structured programs for training in palliative patient care
available in the United States. There are far too few health care professionals
who have been trained or have an interest in dealing with this phase of a
patient's disease. The Hospice movement in this county, through its own efforts,
has developed largely outside mainline, established treatment and educational
centers.
"This RFA proposes to stimulate medical schools... to
design methodologies for the education and training of health care professionals
in hospice and palliative care. Traditionally, the nursing profession has been
more involved with this phase of patient care than physicians. Hospices have had
to struggle with physician recruitment. A major challenge is to train more
physicians in a team approach to palliation. An important target group for
reaching this goal would be medical students during their clinical training
years. At a minimum, what hospice is, issues of hospice care, the practical
aspects of interaction with patients and their families should be considered.
"The NCI hopes to stimulate multi-disciplinary, team
approaches to palliative care by encouraging a variety of educational programs
aimed at medical students, physicians, other health professionals, and hospice
personnel. The ultimate goal is to benefit cancer patients and their families...
"
Abstract of the Original
R25 Grant
Application (submitted June, 1994):
Hospice
and palliative care are neglected areas in health professional training.
Hospice, now recognized as an important and effective means of achieving
palliative care and improving the quality of life for terminally ill patients,
has developed largely outside of mainline, established medical treatment and
educational centers. The terminal phase
of illness is an area of care that many health professionals, and physicians in
particular, have shunned. This is
compounded by the fact that there are few formally structured training programs
in palliative care available to medical students and physicians in the United
States. In response to this need, the
University of Maryland Cancer Center (UMCC), the University of Maryland School
of Medicine (UM-SOM), the University of Maryland Medical Systems (UMMS-represents
the University of Maryland Hospital), the Joseph Richey Hospice and the Bay Area
Home Hospice have collaborated to implement a comprehensive training program in
hospice and palliative care targeted at the education of medical students and
physicians, and at fully integrating the hospice approach to palliative care
within the University of Maryland academic treatment and educational center. To accomplish this, we have formulated the following specific aims:
1. To implement a valid,
structured and multidisciplinary educational program in palliative care at the
UMCC, UM-SOM and UMMS that is designed to produce medical students and
physicians competent to provide such care.
2. To utilize the above
educational program to fully integrate state-of-the-art hospice and palliative
care practices within the academic medical teaching facilities of the UM-SOM,
UMCC and UMMS. The educational programs
proposed will directly impact on all medical students at the UM-SOM, all
residents in internal medicine and family medicine training at the UMMS, and all
Hematology-Oncology fellows in training, all clinical faculty members of
the UMCC hematology and medical oncology division, as well as many clinical
faculty members of the Departments of Medicine, Family Medicine and Pediatrics
of the UM-SOM.
Abstract of the Grant
Application for Competing Continuation of our R25 Grant
(submitted June, 1997):
This
application seeks the competitive renewal of an R-25 grant-funded project whose
long-term goals are to design, implement, evaluate and institutionalize
comprehensive programs of hospice and palliative care education at the
University of Maryland School of Medicine for medical students and physicians
(residents and faculty), and to integrate modern hospice and palliative care
practices within the University of Maryland medical academic treatment and
educational centers. The need to achieve these goals is great, since hospice and palliative
care are neglected areas in the training of physicians.
Prior to the initiation of our efforts in September 1994, only very minor
teaching elements pertinent to the care of dying patients were in place in the
medical school curriculum.
In the last funding period we have defined the terminal and enabling
objectives of an educational program in hospice and palliative care for our
medical students. Integration
of this program as a required element at our medical school can best be
accomplished by placing new content in the Freshman and Junior years.
We have completed and evaluated the integration of the program objectives
into required course work in the Freshman year; However, critical program objectives remain to be integrated and
evaluated in the Junior year. We have also implemented educational sessions on palliative medicine for
residents in Family Medicine and Internal Medicine, and have created a
successful annual series of symposia for Baltimore area physicians on the care
of dying patients. To
continue the development and integration of the educational programs, for the
next funding period, we propose to focus on the medical school curriculum, and
have identified the following specific
aims: 1)
to complete the integration of our educational program in palliative medicine
and hospice into the University of Maryland School of Medicine curriculum by
developing, implementing, evaluating and institutionalizing in the Junior year a
required didactic and practicum rotation in hospice and palliative medicine that
will enable the students to meet the Junior level behavioral objectives;
2) to
develop and implement a plan for the long term evaluation of the educational
program in palliative care that was placed in the University of Maryland medical
school curriculum to determine the retention of the program goals by Senior
students and graduates.
Abstract of the Grant
Application for the most recent Competing Continuation of our R25 Grant
(submitted October, 2000):
This
application seeks the competitive renewal of an R-25 grant-funded project whose
long-term goals are to design, implement, evaluate and institutionalize
comprehensive programs of hospice and palliative care education at the
University of Maryland School of Medicine. In the last funding period, we
integrated a required, 20-hour palliative care educational program into the
medical school curriculum, dispersed in pre-clinical and clinical years.
Satisfactory completion of the palliative care educational program is now a
requirement for graduation. Evaluation indicates that the students are able to
meet the learning objectives; hence, we are now graduating medical students with
basic competency in palliative and end-of-life care. Surveys of our senior
medical students who have completed the program indicate they perceive they are
more competent to handle end-of-life issues than senior medical students in
other medical schools that lack formal end-of-life curricula. For the next
funding period, we intend to focus on palliative care educational programs
designed for residents in internal medicine. The
Internal Medicine residency at the University of Maryland School of Medicine is
a 3-year program with approximately 35 residents in each year, and four chief
residents. The specific aims are: 1)
To develop and institutionalize required training for residents in
Internal Medicine that will provide them with basic competence in palliative and
end-of-life care upon the completion of the residency program; and
2) To develop and implement a plan for formative and summative evaluation of
the program to determine validity and the retention of the program goals by
program graduates. Behavioral objectives for the internal medicine resident as
learner have been delineated. A multidisciplinary educational team will be
responsible for the design of educational modules, content integration, and
pilot/field testing. The team includes respected physician-educator role models,
and key individuals for effecting change in the residency program. Content will
be integrated in venues where all residents can participate, including required
rotations in critical care, geriatrics, Cancer Center, web-based learning
modules, and a planned rotation in palliative and end-of-life care. Plans for
formative and summative evaluation are discussed.