Introduction to the Practice of Medicine II

End of Life content

• Lecture “Raising Difficult Subjects: Advance Directives, Code Status, Notification of Death and Request for Autopsy” includes video clips demonstrating an approach to discussing advance directives and giving bad news to an elderly patient in the presence of his daughter.
• Lecture on “transfer to the physical” with discussion of activities of daily living and the impact of loss of ADL activities to patients
• Lecture on normal aging and the geriatric exam with emphasis on respect for the elderly
• Lecture on the genetics of Alzheimer's disease and genetic counseling

Assessment

“Assessment of the end of life curriculum is done through a written test at the end of the semester questions from each lecture”

“The students are assigned to a preceptor during semester four.   They are expected to do 4 complete H&P's as well as problem lists, positives and negatives, assessment and three-part plan for each patient.   This is an ideal time to introduce end of life care into their thought process”.

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.  

1. death is a natural part of the life cycle

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 covered in didactic, skills not consistently assessed

2. demonstrate appropriate skills and strategies for communication of goals of care with patient and their families (living will, DNR, donor programs)
4. demonstrate appropriate skills and strategies for communication during difficult situations, such as giving bad news
5. demonstrate appropriate skills and strategies for developing advance directives with patient and their families

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.

1. identify the multiple determinants of suffering: physical, psychological, social, cultural, and spiritual

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 addressed, not communication skills)

2. develop an awareness of state, region, and system-specific legal guidelines regarding end of life issues including physician assisted death (does not include physician assisted death)

  © 2001 Loyola University Chicago Stritch School of Medicine. All rights reserved.
Please send questions or comments to: Theresa Kristopaitis, M.D.
Updated: 09/21/04 ... Created: 09/08/04