De Novo Development of an Interprofessional Hospice Palliative Care Case-Based Simulation
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management is insufficient education in our professional training programs, including schools of pharmacy. The purpose of this pre- sentation is to detail efforts made by one school of pharmacy (University of Maryland) to provide required and elective didactic and experiential training opportunities for students of pharmacy, and practicing pharmacists. Methods. The curriculum and post-graduate training activities sponsored by the University of Maryland School of Pharmacy in pain man- agement and palliative care have been reviewed and summarized for this presentation. Results. Required didactic content in pain man- agement and palliative care is present in the pro- fessional curriculum in several basic sciences courses, which serve as the foundation for thera- peutics discussion in courses such as ‘‘Pathophys- iology, Pharmacology and Therapeutics,’’ and ‘‘Pharmacotherapy.’’ Didactic elective courses in- clude ‘‘Care of the Terminally Ill (CTI)’’ and ‘‘Grief and Bereavement Theory.’’ The CTI elec- tive has two primary components: pharmacother- apy and psychosocial issues of advanced illness. A significant amount of active learning is included in this course such as case discussions, maintain- ing an eJournal (write your own eulogy, write a condolence letter, write your bucket list, etc.), a funeral home visit, and the use of games such as Jeopardy. Didactic elective courses that are in development and will be offered in Fall 2011 in- clude ‘‘Opioid Conversion Calculations,’’ and ‘‘Pharmacists and Spirituality.’’ Required and elective experiential coursework is available for fourth year students, as well as the option of work- ing on a special project one-on-one with a faculty member. A range of post-graduate training is available including the first PGY2 Pharmacy Prac- tice Residency in Pain and Palliative Care, and other opportunities. Discussion. The University of Maryland School of Pharmacy has incorporated a significant amount of content on pain management and palliative care for both students, and practicing pharmacists. De Novo Development of an Interprofessional Hospice Palliative Care Case-Based Simulation Jeff Myers, MD MSEd, University of Toronto, Toronto, ON, Canada. Objective 1. Develop an educational experience involving learners from all ten healthcare professions faculties with the specific innovation being a de novo process that itself was interprofes- sional in nature. Background. Responding to a call for greater emphasis on interprofessional educational expe- riences in the curricula of healthcare profes- sions faculties, a formal IPE competency framework was developed at our institution. Given the transprofessional nature of the knowl- edge, skills, and attitudes within the scope of hospice palliative care, this was viewed as an op- portunity to develop an educational experience for learners addressing competency develop- ment in both hospice palliative care-related con- tent and interprofessionalism. An IPE Palliative Care Working Group was formed and given the task of developing an interprofessional palliative care educational experience. Methods. Eleven faculty members (working group lead plus one rep from each faculty) with education as their academic focus and clinical background in hospice palliative care partici- pated in the 2-year process. Faculties represented include medicine, nursing, social work, occupa- tional therapy, physiotherapy, dentistry, speech language pathology, pharmacy, med rad sci, and physical education. The product was an innova- tive facilitated case-based interprofessional expe- rience. Both mock pilot and formal pilot sessions were key elements of the process. Results. The general context for the session is a simulated interprofessional team meeting dur- ing which ten learners represent their respective profession. A dyadic model of facilitation is uti- lized with the overall purpose of the session being to prepare learners for a patient/family meeting during which care goals for a patient with ad- vanced incurable disease are to be addressed. Given tremendous variation in professional pro- gram length (2-4 years) and curricular design for each of the ten faculties, it was determined ‘‘learner readiness level’’ for the session would be defined as ‘‘able to interpret, understand and communicate elements of a clinical assessment of their respective profession.’’ Two examples of learner objectives for the ses- sion are: (1) hospice palliative caredclarify the appropriate uniprofessional roles and interpro- fessional team approach to delivering care when the primary goal of care is to achieve and maintain quality of life as defined by the patient/family. (2) interprofesionalismdunder- stand the role and contribution of each Vol. 41 No. 1 January 2011 251 Schedule with Abstracts
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Transcript of De Novo Development of an Interprofessional Hospice Palliative Care Case-Based Simulation
Vol. 41 No. 1 January 2011 251Schedule with Abstracts
management is insufficient education in ourprofessional training programs, includingschools of pharmacy. The purpose of this pre-sentation is to detail efforts made by one schoolof pharmacy (University of Maryland) to providerequired and elective didactic and experientialtraining opportunities for students of pharmacy,and practicing pharmacists.Methods. The curriculum and post-graduatetraining activities sponsored by the Universityof Maryland School of Pharmacy in pain man-agement and palliative care have been reviewedand summarized for this presentation.Results. Required didactic content in pain man-agement and palliative care is present in the pro-fessional curriculum in several basic sciencescourses, which serve as the foundation for thera-peutics discussion in courses such as ‘‘Pathophys-iology, Pharmacology and Therapeutics,’’ and‘‘Pharmacotherapy.’’ Didactic elective courses in-clude ‘‘Care of the Terminally Ill (CTI)’’ and‘‘Grief and Bereavement Theory.’’ The CTI elec-tive has two primary components: pharmacother-apy and psychosocial issues of advanced illness. Asignificant amount of active learning is includedin this course such as case discussions, maintain-ing an eJournal (write your own eulogy, writea condolence letter, write your bucket list, etc.),a funeral home visit, and the use of games suchas Jeopardy. Didactic elective courses that are indevelopment and will be offered in Fall 2011 in-clude ‘‘Opioid Conversion Calculations,’’ and‘‘Pharmacists and Spirituality.’’ Required andelective experiential coursework is available forfourth year students, as well as the option of work-ing on a special project one-on-one with a facultymember. A range of post-graduate training isavailable including the first PGY2 Pharmacy Prac-tice Residency in Pain and Palliative Care, andother opportunities.Discussion. The University of Maryland School ofPharmacy has incorporated a significant amountof content on pain management and palliativecare for both students, and practicing pharmacists.
De Novo Development ofan Interprofessional HospicePalliative Care Case-Based SimulationJeff Myers, MD MSEd, University of Toronto,Toronto, ON, Canada.
Objective1. Develop an educational experience involving
learners from all ten healthcare professions
faculties with the specific innovation beinga de novo process that itself was interprofes-sional in nature.
Background. Responding to a call for greateremphasis on interprofessional educational expe-riences in the curricula of healthcare profes-sions faculties, a formal IPE competencyframework was developed at our institution.Given the transprofessional nature of the knowl-edge, skills, and attitudes within the scope ofhospice palliative care, this was viewed as an op-portunity to develop an educational experiencefor learners addressing competency develop-ment in both hospice palliative care-related con-tent and interprofessionalism. An IPE PalliativeCare Working Group was formed and given thetask of developing an interprofessional palliativecare educational experience.Methods. Eleven faculty members (workinggroup lead plus one rep from each faculty) witheducation as their academic focus and clinicalbackground in hospice palliative care partici-pated in the 2-year process. Faculties representedinclude medicine, nursing, social work, occupa-tional therapy, physiotherapy, dentistry, speechlanguage pathology, pharmacy, med rad sci, andphysical education. The product was an innova-tive facilitated case-based interprofessional expe-rience. Both mock pilot and formal pilot sessionswere key elements of the process.Results. The general context for the session isa simulated interprofessional team meeting dur-ing which ten learners represent their respectiveprofession. A dyadic model of facilitation is uti-lized with the overall purpose of the session beingto prepare learners for a patient/family meetingduring which care goals for a patient with ad-vanced incurable disease are to be addressed.Given tremendous variation in professional pro-gram length (2-4 years) and curricular designfor each of the ten faculties, it was determined‘‘learner readiness level’’ for the session wouldbe defined as ‘‘able to interpret, understand andcommunicate elements of a clinical assessmentof their respective profession.’’Two examples of learner objectives for the ses-sion are: (1) hospice palliative caredclarify theappropriate uniprofessional roles and interpro-fessional team approach to delivering carewhen the primary goal of care is to achieveand maintain quality of life as defined by thepatient/family. (2) interprofesionalismdunder-stand the role and contribution of each
252 Vol. 41 No. 1 January 2011Schedule with Abstracts
healthcare profession in the context of address-ing goals of care for a patient/family.Discussion/conclusion. To effectively developa de novo interprofessional educational experi-ence, comprehensive interprofessional inputand participation is required. Topics in hospicepalliative care serve as an effective platformto teach skills in interprofessional knowledge,skills, and attitudes.
‘‘The Notebook’’Nancy J. Sharp, BSN CHPN, Iowa Hospice,Johnston, IA.
Objectives1. Develop an educational initiative that would
meet the need for immediate educational re-quirements and encompass the issues relatedto broad-based staff turnover rates.
2. Present required education in an inviting for-mat to increase utilization and retention ofthe material with long-term enhancement ofpatient care outcomes.
3. Utilize a structured delivery format that pro-vides measureable outcomes of utilizationand acceptance of relevance of the material.
Background. With the release of revised hospiceconditions of participation in May of 2008, hos-pice agencies across the United States were giventhe responsibility of developing policies andpractices to meet the broadened requirementsrelated to contractual relationships for enhance-ment of quality of care across all levels of healthcare. In particular, the education requirement asfollows:Condition of Participation Requirement 418:112Standard # 6: Orientation and Training of Staffmust include:A. Hospice Philosophy: Hospice 101B. Pain ControlC. Symptom ManagementD. Principles about Death & DyingE. Individual Responses to DeathF. Patient RightsG. Appropriate Forms required for collaboration:
1. Most Recent Plan of Care2. Hospice Election Form3. Advanced Directives4. Physician Certifications5. Contact Information for hospice staff6. How to Access 24-Hour on-call system7. Specific Medication Information
8. Physician Orders Specific to Each PatientH. Record Keeping Requirements‘‘The Notebook’’ was developed to incorporateall the pieces of required education into an effi-cient and receptive format.Methods. After data analysis of the scope of thisproject, we developed a two team approach. Thefirst team’s focus was on marketing, distribution,and coordination of education opportunitiesand follow through. The second team’s focuswas on preparation of educational material intoa readily accessible format with a variety of deliv-ery methods for group education as well asa self-study format for follow-up education andutilization in ongoing orientation programswithin the facilities. This team also utilizeda peer education process for cross training se-lected educators within the agency for presenta-tion responsibilities.Results. The Notebook concept was developedfurther into the Iowa Hospice Educational Col-laborative Textbook ‘‘At Home with Hospice’’flyer and was distributed to more than 450agencies statewide during the first quarter of2009, with greater than 90% response foradditional information and educational oppor-tunities. By the end of the first year of thisprogram, we had completed 439 educationalevents involving 49% of the facilities contacted.Each educational event was for 1 hour of directeducation. A copy of the self-study format forthe presented topic was then placed in the facil-ity ‘‘Notebook’’ to be utilized with new hires,doubling our educational outreach.Discussion. This educational initiative hasgreatly enhanced the overall end-of-life educa-tion available to personnel at entry level of palli-ative care in facilities with minimal educationfunding. We incorporated the palliative careconcept into a wide variety of state requiredin-services such as HIPAA training and woundcare and found this greatly improved receptionto the time necessary for continuing educa-tion. We have gone on to acknowledge theneed for a short form of the information foragencies not receptive to the full educationformat and have incorporated that into our2010 program.Conclusion. This program quadrupled the out-reach of our education department and en-hanced the receptivity to palliative educationand care approaches in a holistic format.
