Palliative Medicine
ELEC294 / PMDN 616
Department
Internal Medicine
Clinical or Non-Clinical Course
Clinical
Physician Assessed Patient Facing
Yes
Prerequisites
Completion of Phase 2 Clerkships
Goal
Students have a brief encounter with hospice during their Internal Medicine Core Clerkship in the 3rd year but receive no structured exposure or experience to palliative medicine during their medical school career. The Palliative Medicine Rotation focuses on training communication skills and pain & symptom management skills, which are essential for every physician who provides direct patient care. The tenets of palliative medicine as a specialty extend to every physician, and physicians in all fields of practice benefit from understanding of palliative medicine principles. The goal of this M4 elective is to provide exposure to inpatient palliative medicine, basic training in key communication and pain/symptom management skills, as well as approaches to decision-making and caring for the patient (and family) suffering with potentially life-threatening or life-limiting illness. A student on this rotation will gain a more thorough understanding of the tenets of palliative medicine through hands on instruction and active participation in a busy inpatient palliative medicine service, as well as 2 days of experience in the outpatient clinic and telemedicine.
Objectives
At the end of this course, the student will be able to:
1. Patient Care
a. Assess patient and families’ understanding of their situation, diagnoses, and prognosis, and utilize effective strategies to communicate these
b. Determine and describe appropriate goal-based options available to various seriously ill patients and assist families in coming to a decision
c. Assess decision making capacity, and roles of HCDPOA agents and proxies in medical decision making
d. Perform a multidimensional evaluation of various pain syndromes and propose reasonable and appropriate multimodal pain treatment for each
e. Perform a thorough symptom assessment in seriously ill patients, to include dyspnea, nausea, agitation, delirium, insomnia, and other common issues, and propose a reasonable treatment plan for each
2. Systems Based Practice
a. Identify the role of hospice and palliative medicine in providing excellent care for seriously ill patients while ensuring both patient autonomy and good stewardship of health care resources
b. Gain proficiency in discharge planning of complex patients with multiple medical needs
c. Show awareness of the team approach to health care and identify the utility of each member of the team, particularly in the setting of advanced illness
d. Describe the indications, roles, timing, and evidence for both hospice and palliative medicine/care involvement
3. Practice Based Learning
a. Discuss up-to-date palliative medicine topics as they pertain broadly to patient care
b. Demonstrate awareness of medical literature and content relevant to the field of palliative medicine
4. Professionalism
a. Explain why skilled communication, empathy, and excellent pain and symptom management are critically important to performing excellent holistic medical care
b. Identify the role of a physician as it pertains to advanced care planning and goals of care discussion with patients with advanced disease
5. Interpersonal Skills and Communication
a. Develop and utilize effective strategies to establish rapport, assess understanding and communicate difficult information including bad news
b. Identify and respond appropriately to anger, fear, grief, and denial as well as other blocks to effective communication by addressing concerns on both the intellectual and emotional planes
c. Determine goals of care through in-depth discussion with patients and family members
d. Liaison between services as a member of the palliative medicine team in order to balance the needs of the patient and family with the goals of the care teams
e. Communicate with other consultants and primary inpatient teams
6. Medical Knowledge
a. Apply basic medicine concepts learned in third and fourth year to complex medical scenarios
b. Identify common side effects and problems of a range of medications in elderly populations, particularly regarding benzodiazepines, opioids, and antipsychotics as well as various medications that may cause delirium
c. Identify critical areas of knowledge of palliative medicine as it will pertain to each field of practice, including pain and symptom management and communication skills
Method of Assessment
- Standard Clinical 2wk Elective Evaluation - Satisfactory/Unsatisfactory
Course Director
James Adams, MD
Course Coordinator
Ashley Finney
afinney@uic.edu
309-840-7268
Setting
Outpatient
Inpatient
Night Call
No
Laboratory
Yes
Weekends
No
House Staff
Yes
Number of Learners per Block
1
Duration
2 weeks
Who is this elective available to
M4s (in Phase 3)
Blocks Available
All except Fall Break