Improving End of Life Education

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Improving End of Life Education

• Andrew Huchingson
• Tulane University School of Medicine
• New Orleans, LA

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Goals

• Curricular reform as integration
• Building incrementally and gradually over time
• Doing fewer things, but doing those well
• Education as a continuum
• Patient vs. Student centered

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Current Offerings

• First year- 3 large group lectures, 1 small group
  discussion
• Second year- Nothing is offered
• Third year- variable, depending upon experiences
  on Internal and Family Medicine rotations
• Fourth year- also variable

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Lecture One Why?

• Dr. Marschke, welcome to New Orleans!
• Importance of learning about EOL care
• What is Hospice?
• Quality of life vs. Quantity
• Picturing your own death

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Lecture Two Patient Centered

• Interview with a Hospice patient
• -History including spirituality
• -What could be done to improve
• your care?
• -Time for student questions
• To Live Until I Die
• Break class up into smaller groups for a
  facilitator led discussion

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Lecture Three Legalese

• Lets fill out an advanced directive
• Patient rights
• Assisted suicide
• Withholding and withdrawing
• Double effect
• Futility

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Small Group

• A good death?
• Lets talk about how we feel
• Required reading

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Hospice Elective

• Tulane students are required to take a first year
  elective during second semester
• LSU model
• Limit enrollment initially
• Join a Hospice team
• Discussion sessions
• Reasonably easy to set up

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Second Year

• Problem Based Learning Session
• Including pharmacology of pain management
• Could be incorporated into an already utilized
  PBL
• Easy to implement
• Patient centered approach

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Third Year

• Standardized patient
• Bring it all together
• Done during Internal/ Family Medicine rotations
• Has been done successfully at Tulane in the past
• Funding?

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Fourth year

• Add an elective in EOL care

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Video Project

• Follow a single Hospice patient throughout the
  dying process
• What would a student want to know? From a
  students perspective.
• Can include interviews with family members
• Locating a willing patient?

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Success

• Keep it simple
• Improve upon things that already exist
• Faculty support
• Education of faculty is key