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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….