PHYSICIAN HOSPICE/PALLIATIVE CARE TRAINING--UNIPACS

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DESCRIPTION: (Applicant's Description) Few formally structured programs for training in hospice/palliative patient care are available in the United States. The lack of formal medical school training in hospice/palliative care, coupled with a paucity of continuing medical education programs on the same subject, contributes to physician ignorance of effective hospice/palliative patient care techniques, in particular pain and symptom control. The long-term objective of this project is to improve the quality of life of cancer patients and their families by training physicians and medical students to provide effective hospice/palliative patient care, in particular adequate pain and symptom control. Specific aims include: 1) developing a fifteen-hour, nine-module physician training curriculum, entitled "Physician Hospice/Palliative Care Training: UNIPACs," appropriate for use in individual learning and as a supplement for medical student hospice training sessions which offer clinical demonstrations of palliative care in hospice or home settings; 2) field testing and evaluating the effectiveness of each module in the curriculum; and 4) disseminating the curriculum to practicing physicians, hospice programs and medical schools. The curriculum's nine modules will cover: 1)pain management and pharmacokinetics of pain medications; 2) management of selected nonpain symptoms and pharmacokinetics of selected medications; 3) ethical and legal decision making; 4) psychological and spiritual aspects of dying, death, grief and bereavement; 5) the process of dying and the death event; 6) health care in the home setting; 7) health economics and hospice care; 8) the multidisciplinary team approach to care;and 9) communicating with patients/family/team members. Each module, or UNIPAC, will follow the recommended format for self- instructional learning and will include behavioral objectives, a pretest, reading material, descriptions of clinical situations with questions to demonstrate knowledge application, and a post test. To facilitate use, the curriculum will be designed to be readily adaptable to other settings. The curriculum will be distributed on request to hospice programs offering medical student training, medical schools, and members of the Academy of Hospice Physicians.