End-of-Life and Palliative Care Curricula in Internal Medicine Clerkships

Abstract

Although many IM clerkship directors have implemented formal curricula in EOL/PC, a substantial gap remains between those who have implemented and those who believe it belongs in the clerkship. Time, faculty, cost, and competing demands are the main barriers to implementation.

Improving medical graduates' training in palliative care: advancing education and practice

“…Eighty-four percent of those surveyed favored integrating EOL instruction into existing courses or clerkships rather than offering a separate course. In a 2014 survey of internal medicine clerkship directors, Shaheen et al 33 found that 76% of those responding believed EOL and palliative care training should occur in the internal medicine clerkship, yet only 44% reported having formal curricula in EOL/palliative care. Smith and Schaefer also promoted the idea of incorporating palliative care training into core clinical clerkships.…”

Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer

“…A survey of clerkship directors revealed that lectures and small-group discussions were the most common palliative training modalities. 49 However, residents and directors of pediatric residency programs have reported palliative care learning was best accomplished at the bedside (close to an actual encounter) and during rounds as experiential learning opportunities. 45 Structured home visits and hospice rotations within palliative care curricula would enhance personal and professional trainee development.…”

Abstracts from the Center to Advance Palliative Care National Seminar Practical Tools for Making Change October 26–29, 2016 Orlando, Florida

“…Beyond advance directives, the presence of a completed POLST form assures a greater likelihood that an individual's preferences for medical treatment will be honored at the end of life. 1,2 For more than 10 years, the National POLST Paradigm Task Force has assisted states in developing quality standards for POLST programs. To date, 19 states have endorsed POLST programs, 25 have developing programs and 3 states have programs that do not conform to requirements.…”

“…Current approaches to PC teaching are inadequate, primarily preclinical, poorly integrated, focused on knowledge rather than skills and attitudes, and lack opportunity for reflection (Billings, 1997). A survey of Clerkship Directors found 75.8% of respondents felt that PC curricula should occur in clerkships, but only 43.6% had formal curricula (Shaheen, 2014). Early clinical experiences with critical illness, death, and dying have implications on development of students' professional identity, attitudes, and behaviors (Ratanawongsa, 2005 (Fields, 2011).…”

“…(Core)* 1 Review of the accompanying FAQs shows that the RRC allows HPM fellowship programs the flexibility to accept fellows with the expectation of completing the program on a part-time basis over the course of 24-36 months. 2 The division of Geriatric and Palliative Medicine at North Shore University Hospital piloted a part-time fellowship training program in hospice and palliative medicine on July 1st, 2015. The program is in its second year.…”