Curriculum for Post-Graduate Education: Comparing Hospice and Palliative Care Medicine

Abstract

Abstract Introduction Increased knowledge and confidence in caring for patients during their end-of-life stages is vital to resident training. As the elderly population continues to grow, it is crucial that physicians meet the rising demand for competent end-of-life care and appropriately refer them to palliative and hospice care. This teaching tool is a case-based discussion module that was created to educate internal medicine residents about the differences between palliative care and hospice care so that they may apply their understanding to day-to-day practice and refer patients appropriately. Methods The module is divided into two parts: the goal of the first part is to engage learners at their current knowledge level through a “buzz word” activity. Learners are split into small groups and asked to offer descriptive words for hospice or palliative care. Through group discussion facilitated by the instructor's inquiry of these “buzz words,” the group actively compares and contrasts the defining features of palliative care and hospice care. The second part of the module introduces an unfolding case that allows learners to apply their understanding of the defining features of the two services. Through facilitated case discussion, groups discuss next steps in management and explore how these next steps may help in determining when to appropriately refer patients to palliative and/or hospice care. The entire module is completed in one hour. Results Approximately 20 residents participated in this case-based discussion. Nine residents (who were present at the beginning of the conference) were able to take a pretest. Six of the nine residents (who were able to remain until the end of the hour) took a posttest. Mean score of the pretest was 68%. Mean score of the posttest was 78%. Discussion This case-based discussion module helped residents to gain greater knowledge and confidence in their management of patients at the end of life. Although limited by attendance, we were able to see an objective improvement between pre- and posttest mean scores. Residents specifically expressed greater confidence in understanding the indications for referring patients to the palliative care and hospice services at the conclusion of the module. Additionally, the palliative care and hospice care services at our institution noticed greater awareness, utilization, and understanding amongst the group that had participated in the teaching module.

Keywords

• Palliative Care
• Graduate Medical Education
• Hospice Care