MDE 8150T: Intro to Palliative Medicine and Hospice Tampa 15-16

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Last updated: Apr 28, 2015
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NOTE: Any interested student MUST meet with Dr. Oberoi-Jassal to plan the elective.  Ideally this should be done at least 1 month prior to the start of the rotation. 

This elective is designed to introduce fourth year medical students to palliative care in an oncology setting.  Under the supervision of clinical faculty, students will have the opportunity to rotate on the inpatient consultative service and in the outpatient palliative care clinic at H. Lee Moffitt Cancer Center.  This elective will provide students with experience managing the complex care of patients with advanced illness and at the end of life.  Students will be exposed to comprehensive interdisciplinary symptom assessment and management including chronic pain, dyspnea, nausea, constipation, anxiety, depression, insomnia and decreased appetite.  In addition, students will develop communication skills and techniques to break bad news and have meaningful advance care planning discussions.  

Objectives

  1. Describe the domains of palliative care and outline means to address each domain in seriously ill patients. (Structures and processes, physical, psychological and psychiatric, social, spiritual, cultural, care of the imminently dying patient, and ethical and legal aspects of care)
  2. Recognize how to effectively assses and manage complex symptoms including dyspnea, nausea, constipation, anxiety, depression, insomnia and decreased appetite.
  3. Describe the principles of pain management in patients with chronic life limiting illness.
  4. Describe how to work collaboratively to deliver comprehensive palliative care through an interdisciplinary team approach.
  5. Demonstrate patient-centered interview techniques when giving bad news or clarifying goals of care.
  6. Develop the communication skills to hold a successful family meeting and hold meaningful advance care planning discussions.
  7. Evaluate what is normal and expected in the dying process, how to address these symptoms and guide caregivers in their understanding.
  8. Distinguish the services of inpatient hospice versus home hospice and recognize which patients are appropriate for referral to each service.

  9. Recognize patients that would benefit from specialist palliative care referrral.

Students will see patients on the  H. Lee Moffitt Cancer Center palliative care inpatient consultative service and in the outpatient supportive care medicine clinics.  They will be directly involved in patient care by taking histories, performing physical examinations and developing an assessment and plan, and will have advance care planning discussions with patients and participate in family meetings.  Students will participate in weekly interdisciplinary team meetings, didactic lectures, monthly specialty conferences and the monthly Palliative Care Journal Club during their elective rotation. Student will participate in weekly required journal article reading (articles will be given) followed by discussion of the topic. Upon completion of this elective, students will be able to describe core principles of comprehensive palliative care and will be able to effectively recognize, assess and manage complex symptoms in the seriously ill patient.  Students will be able to effectively give bad news, discuss advance care planning, and identify symptoms common at the end of life and manage them.

Evaluation
Students will be evaluated based on clinical evaluations completed by the course director.  There is a graded oral presentation of a topic of interest in palliative care, graded by the attending physician.  Grades are determined by: 40% clinical evaluations, 25% assessment and completion of patient interviews/clinical notes and required journal article reading, 25% oral presentation and 10% professionalism.