Four-year palliative care curriculum focuses on support for patients with serious illness
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The medical profession has increasingly embraced palliative care as a key component of patient-centered therapy.
To better reflect the increased role of palliative care in clinical practice and educate future physicians in this area, some medical schools have begun to incorporate palliative care as part of their training.
Perelman School of Medicine at the University of Pennsylvania has taken this a step further by introducing CARE-7, a comprehensive, 4-year palliative care curriculum.
“In the past, we’ve been focused more on the life-prolonging aspect of medical care,” CARE-7 curriculum director Alana Sagin, MD, associate professor of hospice and palliative care at Perelman School of Medicine, told Healio. “Nationally, there has been a growing recognition that the quality-of-life piece is also very important. We have been working for a long time to incorporate these aspects into our curriculum.”
Healio spoke with Sagin about the goals of the CARE-7 curriculum and the benefit to patients that would be possible through a physician workforce trained in primary palliative care.
Healio: How did this curriculum come about?
Sagin: About a year ago, we were approached by a generous donor who was interested in having a comprehensive palliative care curriculum in the medical school. That really jump-started this more robust focus for us.
Healio: There have been some misconceptions around palliative care — it is often assumed to pertain to the end of life. Is this still true?
Sagin: I believe there are still some misconceptions, although less so. Palliative care is a specialty designed to enhance quality-of-life for patients with serious illness. That can happen alongside other treatments they are getting and while they are pursuing curative or disease-modifying treatments. It can happen at any stage of a serious illness. I should also mention that there are specialist-level ,and primary palliative care skills, which is what we are working on in this curriculum. We want to make sure that every physician has the basic skills and communication to support patients in their symptom management.
Healio: What will medical students learn as part of the CARE-7 curriculum?
Sagin: CARE-7 is named for the seven learning domains we include in our curriculum, including knowledge about palliative care, compassionate and effective communication, and pain and symptom management. Because we know physicians are going to care for patients with serious illnesses that impact quality of life, we think every physician should have a basic skill set in these areas.
As part of the CARE-7 curriculum, students progress through specific phases of training. The first step for preclerkship students is an introduction to the core concepts and skills of palliative care and exposure to clinical palliative care. Next, clerkship students build on this training by learning more advanced skills and concepts, which they are challenged to apply clinically. Finally, postclerkship students practice advanced skills specific to their area of interest and have the option to seek additional training through electives. Each step involves both direct patient care and simulation.
Healio: Does the current lack of primary palliative care education make some clinicians uncomfortable providing palliative care?
Sagin: As a palliative care consultant in hospitals, I’m often aware that primary medical teams could be managing some of the issues for which I’m consulted, if only they had the basic skill set and the confidence in themselves to do it. We are trying to turn out physicians who are comfortable with some of the more predictable situations that arise in patients with serious illness. These situations require physicians to have skilled conversations and knowledge about symptom management.
Healio: Is there anything else you’d like to mention about CARE-7?
Sagin: I believe this is part of a broader cultural change. I hope there will be enough change in this area that a curriculum like this will be an expected part of medical education in the future. I would also emphasize that communication is a major part of our curriculum. That is important, because communication skills are so universally applicable. They require deliberate practice to improve. We treat them like a procedure, and use trained faculty and simulated patients to let students practice these skills in a safe way. We hope to foster physicians who can continue to improve their communication skills throughout their careers.
Reference s :
- Healio Interviews
- Perelman School of Medicine launches leading palliative care curriculum focused on caring for patients with serious illness (press release). Available at: www.pennmedicine.org/news/news-releases/2022/september/psom-launches-leading-palliative-care-curriculum. Published Sept. 12, 2022. Accessed Oct. 7, 2022.
For more information :
Alana Sagin, MD, can be reached at Hospital of the University of Pennsylvania, White Building, 2nd Floor, 3400 Spruce St., Philadelphia, PA 19104; email: alana.sagin@pennmedicine.upenn.edu.
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