Surgery
End of Life Content
- The students will participate in a lecture/discussion on end of life issues in the surgical patient
- The students will have the opportunity to witness and potentially participate in end of life decisions through patient care
Assessment
The students will write a brief synopsis of end of life issues or palliative care issues in one patient encountered during their 12 week surgery clerkship
End of Life Curriculum Goals and Objectives addressed
Goal #1 Medical Knowledge
Students must demonstrate knowledge about the medical aspects of death and dying, as well as the skills and attitudes necessary to use this knowledge effectively as a physician.
- death is a natural part of the life cycle
- the concepts and philosophy of palliative care
- the pathophysiology and management of the common symptoms encountered at the end of life
- pain
- nausea and vomiting
- dyspnea
Goal #2 Communication Skills
Students must demonstrate knowledge of the principles of communication and the skills and attitudes that allow effective interactions with patients, families, healthcare workers, and others who affect the well-being of patients at the end of life
- demonstrate appropriate skills and strategies for communication of goals of care with patients and their families
- demonstrate and understanding of the impact of life-threatening illness on patients and their families
- demonstrate appropriate skills and strategies for developing advance directives with patients and their families
- effectively communicate with patient and families in the face of sudden illness
Goal #3 Professionalism
Students must demonstrate a combination of knowledge, skills, attitudes, and behaviors necessary to function as a member of the health care team caring for the dying.
- identify the major obligations of physicians to their patients at the end of life
- reflect on personal and professional experiences around death and loss
Goal #4 Patient Care
Students must use their knowledge, skills, and attitudes to provide patient care at the end of life that is appropriate, effective and sensitive to the psychological, sociologic, cultural and spiritual aspects of death and dying.
- develop and implement a care plan for patients when cure is no longer a rational goal and health services are most appropriately directed at comfort
- apply knowledge to effectively evaluate and manage the most common physical symptoms encountered at the end of life
- apply knowledge of the points of consensus and controversy to make reasonable judgements regarding the following ethical aspects of end of life care
- withholding treatment
- withdrawing treatment
- pain management
- non-abandonment of patient
- access of patients to high quality and end of life care
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