Behavioral Development
End of Life content
- 1 hour lecture – Spiritual Development Across the Life Span
- 1 hour lecture – Introduction to Aging; addresses several issues including that death is a natural part of life; etiology of delirium as it relates to the aged
- Panel Discussion on Aging
- 1 hour lecture and 1 hour panel discussion on Disability
- 1 hour lecture on Care of the Dying Patient
- Required reading – Baxter DJ, The Least of These My Brethren: A Doctor's Story of Hope and Miracles on an Inner-City AIDS Ward with 2 hour book discussion
- Required reading Stoudemire A. Human Behavior: An Introduction for Medical Students with sections addressing death and dying; the doctor- dying patient relationship and supportive psychological care of the medically ill
Assessment
“There are approximately four questions based on each BD lecture listed for each session. BD exam topics are cumulative: questions may reflect all lecture material and required reading from the start of the course up to the date of each exam”.
End of Life Curriculum Goals and Objectives Addressed
Goal #1 Medical Knowledge
Students must demonstrate knowledge about the medical aspects of death and dying, as well as the skills and attitudes necessary to use this knowledge effectively as a physician.
- death is a natural part of the life cycle
- the concepts and philosophy of palliative care
- the pathophysiology and management of the common symptoms encountered at the end of life
- pain
- delirium (addressed but not in context of EOL care)
- depression (addressed but not in context of EOL care)
- the potential adverse effects of common medications used for control of symptoms of terminally ill patients (opioid and non-opioid analgesics)
- the World Health Organization pain ladder
- the principle of double effect
Goal #2 Communication Skills
Students must demonstrate knowledge of the principles of communication and the skills and attitudes that allow effective interactions with patients, families, healthcare workers, and others who affect the well-being of patients at the end of life. (knowledge of concept assessed, not communication skill)
- demonstrate an understanding of the impact of life-threatening illness on patients and their families
- demonstrate an understanding of how family, culture, and religious beliefs can influence healthcare decision and outcomes at the end of life
Goal #3 Professionalism
Students must demonstrate a combination of knowledge , skills, attitudes, and behaviors necessary to function as a member of the health care team caring for the dying.
(knowledge of concept assessed, not skills, attitudes and behaviors)
- identify the major obligations of physicians to their patients at the end of life
- reflect on personal and professional experiences around death and loss
Goal #4 Patient Care
Students must use their knowledge , skills, and attitudes to provide patient care at the end of life that is appropriate, effective and sensitive to the psychological, sociologic, cultural, and spiritual aspects of death and dying. (knowledge of concept assessed, not patient care skills)
- identify the multiple determinants of suffering: physical, psychological, social, cultural, and spiritual
- identify the psychological, sociologic, cultural, and spiritual aspects of loss and bereavement
- apply knowledge of the points of consensus and controversy to make reasonable judgements regarding the following ethical aspects of end of life care
- withholding treatment
- withdrawing treatment
- nonabandonment of patients
Goal #6 Social and Community Context of Healthcare
Students must demonstrate the knowledge, skills, attitudes necessary to function within the larger healthcare system in which they will receive further training and identify resources available to provide high-quality care for their patients. (knowledge of concept assessed, not skills and attitudes)
- demonstrate knowledge of the philosophy of hospice and the services provided by a hospice program
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