Pain and Palliative Care Curriculum

PAIN AND PALLIATIVE CARE CURRICULUM

Faculty: Roman Kozyckyj MD

Learning Objectives

The learning objectives of the Pain and Palliative Care Curriculum are as follows:

Pain Management: Upon completion of this rotation the residents will be able:

To demonstrate ability tounderstand the types of pain, pathophysiology, and harmful effects
Todemonstrate ability to assess pain inclusive of a comprehensive history and pertinent examination
Todemonstrate ability to use tools to assess pain severity
To demonstrate ability toknow the modalities of pain management
Todemonstrate ability to monitor pain therapy
To demonstrate ability tomanage acute and chronic pain
Todemonstrate ability to work within the team organization and pain care services at Advocate Christ Medical Center
To demonstrate ability toreview current literature with respect to pain management

Palliative Care: Upon completion of this rotation, the participant will be able:

To demonstrate ability tounderstand the goals of palliative care and hospice philosophy
To demonstrate ability toidentify dimensions of care included in hospice/palliative care philosophy:

Physical
Emotional
Psychosocial
Spiritual
Grieving/bereavement
Ethical and legal aspects of care

To demonstrate ability torecognize appropriate patient population to whom palliative care should be offered
To demonstrate ability tocommunicate effectively with patients, families, members of the interdisciplinary team about goals of palliative care and where appropriate about death and dying
To demonstrate ability toassist patients in identification of goals related to end of life care
To demonstrate ability toassess and manage pain and various other symptoms in the dying patient
To demonstrate ability todescribe the role of each of the following team members:

Physician
Nurse
Nursing Assistant
Social Worker
Chaplain
Bereavement counselor
Volunteers

Todemonstrate ability to discuss ethical issues related to death and dying
To demonstrate ability toidentify appropriate care strategies at the time of dying

General Competencies

Patient Care

Todemonstrate ability to perform a comprehensive history and examination in a patient with pain or a palliative care candidate
Todemonstrate ability to review available data in the valuation of a patient with pain or a palliative care candidate
To demonstrate abilityto review medical records in the evaluation of a patient with pain or a palliative care candidate

Todemonstrate ability to perform a comprehensive assessment of the level of care needed
Todemonstrate ability to communicate effectively with family, patients, attending physicians, team members
Todemonstrate ability to define goals of care with respect to pain and palliative care
To demonstrate abilityto follow-up and monitor implemented plans
To demonstrate abilityto monitor a patient’s response to intervention
Todemonstrate ability to work within a team

Medical Knowledge

Todemonstrate ability to know the pathology, pathogenesis, clinical features, treatment and prevention of pain syndromes
Todemonstrate ability to know the concepts of palliative care and goals of care
Todemonstrate ability to use evidence-based medicine to evaluate each patient in terms of clinical-decision making, critical thinking and problem solving with respect to pain management and palliative care

Practice-Based Learning and Improvement

To demonstrate ability toresearch and learn from patient care issues with respect to pain management and palliative care services
To demonstrate ability toanalyze the reason for the consult and evaluate the patient appropriately
To demonstrate ability touse evidence-based medicine and use the available literature to support clinical judgment

Interpersonal and Communication Skills

To demonstrate ability toprovide effective communication with the patient and family members
To demonstrate ability tocommunicate effectively with all team members
Todemonstrate ability to be able to comprehensively explain all goals and terminologies of pain and palliative care
To demonstrate ability tobe able to assess response to therapeutic interventions
To demonstrate ability tocommunicate with the primary attending and all involved consultants
To demonstrate ability tomaintain legible medical records

Professionalism

To demonstrate ability tounderstand and appreciate the role of pain management and palliative care
Todemonstrate ability toappreciate the role of the sub-specialists and the Advanced Practice Nurse involved therein
To demonstrate ability tobe available to the primary physician, patient and the family members
To demonstrate respect, compassion, integrity, and altruism in relationships with patients, families, and colleagues

Systems-Based Practice

To demonstrate ability tounderstand, access and utilize the resources, providers and systems necessary to provide optimal care
To demonstrate ability tocollaborate with other members of the health care team to assist patients and to improve care
To demonstrate ability toto appropriately delineate relationships between the consulting service and the primary service

Educational Environment

1.CONFERENCES

Lecture on Pain Management at Noon Conference. Ethics Lectures which occur on every last Friday of the month and deal with multiple issues involving end-of-life issues.

Grand Rounds on Pain Management

Morning Report: The Resident on the service will be encouraged to present a case that he/she has recently been actively involved with. He/she will present all aspects of pain management or palliative care services offered.

4. Patient-based activities: This includes in-patient consult rounds as well as patient care in

the ambulatory set-up

The residents will be able to see in-house consultations independently
Assess the situation and formulate a medical plan
Discuss the same with an APN, this will provide opportunity for learning
In the ambulatory set-up, the residents will spend about one-half day per week and learn aspects of chronic pain management

FACULTY

Educational Coordinator: Dr. R. Kozyckyj

Palliative Care Nurse Manager:

Evaluation and Feedback

Residents are observed and evaluated by their teaching attending as well as an advanced practice nurse (APN) who observes their performance during the rotation. The UIC/ACMC New Innovationforms will be used for evaluations. Attendings will discuss the evaluations with the residents and provide verbal feedback during and at the end of the rotation.

It may not be possible to experience a wide spectrum of patient, patient family, and medical condition scenarios during the rotation. Residents are expected to supplement their learning by self-directed and directed/assigned activities

SERVICE EXPECTATIONS OF RESIDENTS DURING ROTATION

All residents are expected to demonstrate professionalism with respect, compassion, and attentiveness to timeliness and dress behaviors. Any scheduled absences must be discussed and approved by the attending faculty. Any unexcused absences and lack of participation in the activities of the rotation will be unacceptable.

EXPECTATIONS FOR ACHIEVEMENT OF SPECIFIC MILESTONES DURING ROTATION

GOAL: Facilitate and lead family meetings

MILESTONES FOR PGY-1, PGY-2/3

PROF-1 Consistently respectful in interactions with patients, families, caregivers, and

members of the inter-professional team , even in challenging situations.

ICS-1 Engages patientsand family in shared decision making in uncomplicated

conversations

ICS-1Establishes a relationship with patient, family and caregivers, including people

of different socioeconomic and cultural backgrounds

PBLI-1 Self-reflects upon one’s performance and acts upon reflection and feedback to

improve.

GOAL: Lead and work within inter-professional teams

MILESTONES FOR PGY-1, PGY-2/3

SBP-1Understands the roles and responsibilities of and effectively partners with all

members of the team

ICS-2Actively engages in collaborative communication with all members of

inter-professional team

PROF-1 Respects and acknowledges input of inter-professional team and incorporates

their input into plan of care as appropriate.

PROF-4 Demonstrates integrity, honesty, and accountability to patients, families, inter-

professional team member and to the profession.

11/22/14

07/10/17