Education of medical students about end-of-life care, palliative care and hospice care is poor. The Liaison Committee for Medical Education (LCME) requires all medical schools to teach this subject. Prevalent medical school curricula are limited by providing for primarily didactic courses in the preclinical years. Therefore, development of a curriculum that can be incorporated into existing, already full medical school curricula is needed. We have been interested in medical student education at the Center for Palliative Studies at San Diego Hospice for many years. Our experience with a 16-hour course as part of the junior year rotation in medicine suggested that a longer, more structured course was needed. We successfully piloted a 32-hour curriculum for feasibility and to see if evaluation measures showed evidence of changes. We propose to study a 32-hour curriculum in hospice and palliative medicine. The curriculum is designed to introduce important knowledge and skills on the first day. Then students participate in the care of patients of San Diego Hospice, a teaching and research affiliate of the University of California, San Diego. They see patients both in the 24-bed inpatient unit and in the 450 patient census home care program. On the last day, they present a patient they have seen using a structured """"""""whole patient assessment"""""""" in the context of an interdisciplinary team discussion. They present a subject to their classmates and present a """"""""personal project"""""""" that represents their personal engagement with the subject of palliative care. The course will be evaluated using a self-assessment of competencies, attitudes and concerns and a 50 question test of knowledge. An assessment will be performed before the course, at the end of the course, during the senior year, and during residency. Data will be compared with residents who have not been through the course as well as with residents and faculty participating in another study of education.
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