21.1 (4.2) Teaching and training in palliative medicine Flashcards
Research suggests that what type of person is needed in order to successfully integrate PC teaching into a busy undergraduate curriculum
Champion
The palliative education assessment tool recommended that seven domains are presented in undergraduate education on PC. What are those domains?
palliative care perspective at EOL pain neuropsychological symptoms other symptoms patient/family/non-clinical caregiver clinical communication skills ethics and the law
In competency based education the objectives of training drive assessment and assessment drives learning. Based on that what five things should the objectives of training be?
specific measurable achievable relevant timely
SMART
You are part of an undergraduate curriculum planning committee and are looking at ways to increase exposure to PC. List 3 ways that PC KNOWLEDGE can be transmitted
lectures
tutorials
group based discussion
You are part of an undergraduate curriculum planning committee and are looking at ways to increase exposure to PC. List 3 ways that PC SKILLS can be transmitted
problem based learning role play goldfish bowl discussions consultation with simulated patients supported observed hospice visits clincal attachments
Not all physicians work closely with patients who face death and dying. However four basic skills are felt to be reasonable knowledge for all types of doctors. What are these skills?
- communication skills
- assessing a patient’s needs and preferences
- advance care planning
- symptom control
Newly qualified doctors do not feel adequately trained to take over the care of patients with PC needs. What are 3-5 aspects of care that doctors do not feel comfortable with?
lack confidence in breaking bad news
empathizing
discussing prognosis
symptom control
managing distress and social issues
What are the four steps to acquiring skills as laid out in Millar’s pyramid?
bottom -> top
Knows - MCQ
Knows how - matching questions
Shows how - OSCE, SIM
Does - multisource feedback
What is the relationship between material covered on an examination and its perceived importance? What impact has this had on PC teaching?
tend to see areas not covered on examinations as less important
assessment of PC skills is critical in improving students and doctors attitudes towards and skills in PC
You are part of a committee that is trying to determine if a new PC training program in undergraduate medical education was successful. The goal of the program was to reduce the number of pain crises that patients on a clinical teaching unit experience.
What are the four levels of assessment that can be reviewed
level 1 - learner’s reaction to teaching
level 2 - changes in knowledge attitudes skills the learner has acquired
level 3 - the degree to which the learner applies what they have learned to practice
level 4 - whether the desired outcomes occur because of the learning acquired at the learner or organizational level
Learner rxn -> knowledge -> application
Clinical changes
What is the relationship between physician self assessment of communication skill and family perception of the quality of communication
the more confident the trainee the lower the family rating was
What professional attitudes negatively impact the delivery of palliative care
seeing death as a failure
therapeutic nihilism in patients with cancer or other end stage disease
wishing to avoid dying patients
fears about opioids
What ways can you change professional attitudes about palliative care
- increase knowledge
- role modeling
- facilitated discussion and reflection following clinical encounters
