Expanding Education in EOL Care at Wayne State University SOM

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Expanding Education in EOL Care at Wayne State
University SOM

• Juan Geldres, MS II
• July 30, 2004

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Objectives

• To introduce medical students to EOL care and its
  role in health services delivery through
  experiential, interactive and didactic methods
• To help students understand the psychological,
  sociological, cultural and spiritual aspects of
  death and dying
• To help students recognize and respond to
  cultural, linguistic and spiritual diversity
• To improve students ability to reflect
  self-critically on personal and professional
  experiences, views and beliefs surrounding death
  and loss

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EOL/Palliative Medicine Curriculum at WSU SOM

• Year I
• Co-curricular seminar/hospice volunteering
• DD Interest Group activities
• Year II--Clinical Medicine course
• EOL lectures (prognostication, pain mgmt.,
  advanced care planning, hospice, foregoing futile
  treatment)
• Small group meetings (advanced care planning,
  difficult EOL decisions)

• Year III
• Lecture on Breaking Bad News
• Hospice visit during Family Med rotation
• Advanced care planning exercise with pt. in
  Continuity Clinic Clerkship
• Year IV
• 12-hr. EOL seminar series in Ambulatory Med
  rotation
• 1-mo. Hospice Elective
• Palliative Medicine elective (new in 07/04)

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2003-04 Activities of WSU chapter of AMSA Death
Dying Interest Group

• Saturday morning seminar introducing students to
  Hospice and Palliative Care
• Lunchtime lecture on Communicating Bad News,
  given by Dr. John Finn
• Lunchtime panel covering religious considerations
  in EOL care, as part of Ethnic Week
• Movie night and discussionWit
• Shadowing of Hospice physician during house calls

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Small group lunch topics

• Picturing Death exercise
• Use Deborah Boardmans Picturing Death journal
  exercise (www.deborahboardman.com)
• Have students write about and discuss their
  perceptions of what a good death is
• Have students write about and discuss their ideal
  death room

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Small group lunch topics (contd)

• Philosophical discussion on Death Dying
• What would happen if man were immortal?
• What is suffering?
• What happens after we die?
• How does religion/spirituality affect our views
  of life and death?

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Small group lunch topics (contd)

• Documentary viewing and discussion
• To Live Until I Die
• Letting Go A Hospice Journey (HBO, 1996)
• On Our Own TermsBill Moyers series

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Small group lunch topics (contd)

• Book/essay discussion sessions
• Assign short stories/excerpts to read and
  initiate group discussion
• Barnard, David. Crossing Over Narratives in
  Palliative Care
• Byock, Ira. Dying Well Peace and Possibilities
  at the End of Life
• Tolstoy, Leo. The Death of Ivan Illich
• Involve students by asking them to select reading
  or article

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Small group lunch topics (contd)

• Communication Skills Workshop
• Reinforces lunchtime lecture given by Dr. Finn
• Provides students with opportunity to practice
  communicating with patients in difficult
  situations
• Provides students with opportunity for
  self-assessment and improvement through
  videotaping of interviews

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Small group lunch topics (contd)

• Legal and Ethical Issues in EOL Care
• Explain and educate about various topics
• Informed consent
• Withholding and withdrawing treatments
• DNR orders
• Physician-assisted suicide
• Provide case studies for students to consider and
  discuss

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Small group lunch topics (contd)

• Sharing of student experiences about illness and
  death
• Initiate writing workshop employing format used
  by Dr. Hauser
• Have students write about illness from
  perspective of the body of an ill person
• Have students write about their experiences in
  dissecting cadavers in anatomy
• Organize panel of MS-III/IV and/or residents to
  share their experiences with dying patients

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Thank you!!

• Horizon Hospice
• Dr. Mike Marschke
• Cari Bagcus
• Staff
• Hospice of IL
• Schuyler Cunningham
• Staff
• Vitas Hospice
• Laura Walker
• Staff

• AMSA
• Joan Hedgecock
• Brittany Bettendorf
• Dr. Mike Stellini
• Fellow Participants