) A fourth year clerkship is proposed in which medical students will learn how to manage medical problems in palliative care and how to function as a member of an interdisciplinary hospice team. Students will also be taught skills in dealing with emotional, spiritual, and communication issues as well as how to address family needs and those of the patient. The four- week clerkship will include: 1) a problem- based learning seminar in which students study medical care in patients with advanced cancer and emotional, social, economic, and spiritual issues in palliative care; 2) a family caregiver seminar in which students learn about family problems and needs and how to guide family caregivers in solving caregiving problems and how to work cooperatively with health professionals as members of the health care team; 3) a death and loss seminar in which students read material about dying, view films on this subject, reflect on their own feelings, and carry out assignments to observe and write about family dynamics and communications issues in their field experiences; 4) attendance at hospice team meetings; 5) accompany hospice physicians, nurses, and social workers on home visits; 6) meet with a family to teach and support them in solving caregiving problems; and 7) function as a home health aide and provide respite care for a hospice patient. The course is unique in its use of problem-based learning, in having students teach problem- solving skills to family caregivers, and by closely linking students' reflection about emotional and spiritual issues through field experiences with patients and families who are confronting those issues. The design of this clerkship and the educational materials developed for it are easily exportable to other medical school curricula.
