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End-of-Life Care Curriculum. Melanie Johnson, MSII Wake Forest University School of Medicine. Outline. Overview of current curriculum at WFUSM Improving the curriculum My plan of action For 2003-2004 For 2004-2005 and beyond. Overview of current curriculum.

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End of life care curriculum

End-of-Life Care Curriculum

Melanie Johnson, MSII

Wake Forest University

School of Medicine


  • Overview of current curriculum at WFUSM

  • Improving the curriculum

  • My plan of action

    • For 2003-2004

    • For 2004-2005 and beyond

Wake forest university baptist medical center hospice and palliative care center overview
Wake Forest University/Baptist Medical Center& Hospice and Palliative Care CenterOVERVIEW:

  • Medical School Curriculum

    • HPCC Medical Director & Staff of WFUBMC

  • MS Is

    • Lecture to whole class and then small group discussion of the issues raised

  • MS IIs

    • Lecture and small groups

  • MS IIIs

    • (Now) 32 hours during Ambulatory Medicine rotation

Dr. Richard Stephenson WFUBMC

Current msi msii schedule
Current MSI & MSII Schedule

  • Lectures and small group discussions

    • Small groups consist of

      • 2 professors (1 M.D. and 1 Ph.D.)

  • Topics include but are not limited to:

    • Hospice and Palliative Care

    • Communicating Bad News

    • Advance Directives

Msiii rotation 2002
MSIII Rotation (2002)

  • Every Wednesday during Ambulatory Medicine

  • All MSIIIs (9 or 10 each month)

  • H&P, POC, Eval form, and “Reflection Paper”

  • Favorite, “most meaningful” rotation

Dr. Richard Stephenson WFUBMC

Current msiii schedule
Current MSIII Schedule

Dr. Richard Stephenson WFUBMC

Medical interns residents and fellows


3 to 5 Half days

Practical review of the Medicare Hospice Benefit

Who qualifies & what do they get

Pain 101 and 201 (opioids)



3rd year residents electives

Some didactics

Lots of direct patient care



First-responder for consults at WFU/BMC

House calls

Fellows elective

Geriatric, Hem/Onc, General IM

Everything 3rd year Resident does plus…

Research a topic

More of a role in teaching

Presentation to hospice clinical staff

Fellowship in Hospice and Palliative Care

being implemented this academic year

Medical interns, residents and fellows…

Dr. Richard Stephenson WFUBMC


  • Bridge the gap between the first 2 years of med school and the 3rd year rotation

  • Allow opportunities for students to have direct exposure to hospice and palliative care before the 3rd year rotation

  • Enhance communication skills

  • Enhance knowledge of the psychosocial aspects of hospice and palliative care

Improving 1 st and 2 nd year
Improving 1st and 2nd year

  • Incorporate additional lectures into the following classes

    • Doctor Patient Relations

    • Medicine as a Profession

  • Suggested lecture topics:

    • Cultural Sensitivity

    • Spirituality

    • Grief and Bereavement

    • Family counseling/conferences

Outcomes msiii rotation evals 2001
Outcomes MSIII Rotation Evals 2001

(1= no opportunity to learn…5= outstanding opportunity)

Dr. Richard Stephenson WFUBMC

Msiii rotation evals 2001 cont
MSIII Rotation Evals 2001 (cont)

Dr. Richard Stephenson WFUBMC

Improving the 3 rd year
Improving the 3rd year

  • Suggested lectures

    • Hydration and IV use

    • Physiology of dying

    • Ethical Issues

      • Physician assisted suicide

      • Withdrawing and withholding care

  • Dealing with personal feelings

    • Debriefing exercises

    • Small group discussions

    • Journaling

For 2003 2004
for 2003-2004

  • Spread the word

    • Distribute brochures in student mailboxes

    • E-mail the entire student body

    • Post signs on bulletin boards

  • Lunch meeting/information session

    • Overview of hospice and palliative care

      • Background information

      • Video “To Live until I die”

    • Need for awareness and education

    • Sign up sheet to become volunteers

  • For interested students

    • Train them to become volunteers at the Kate B. Reynolds Hospice Home

    • Will be assigned a patient and will follow the patient and family throughout the dying process

    • Provide shadowing with the interdisciplinary team

For 2003 2004 cont
for 2003-2004 cont…

  • Forming Partnerships

    • With SNMA to increase African American and other minorities awareness of hospice and palliative care in Winston-Salem, NC

    • With the Geriatric Interest Group

    • With AMSA to implement the “Death and Dying” component at WFUBMC

Plan for 2004 2005 beyond
Plan for 2004-2005 & beyond…

  • To integrate several lectures into the 1st and 2nd year courses

  • Apply for funding from WFUBMC to form a special interest group

    • Hold extensive monthly seminars and workshops

    • Promote group activities and additional volunteer experiences.

The end

The end….