2024-2025 M3/M4 Course Syllabi
Family & Community Medicine
COURSE NUMBER:
06 01 53
TITLE:
PALLIATIVE CARE -ICE
Palliative and hospice care focuses on quality of life for patients with life-threatening illnesses and their families. The student's time will be split between palliative care and hospice. There are two spots available most months - one with an adult palliative care team, one with a children's palliative care team. Relevant medical, legal, ethical, cultural, spiritual, and psychological topics will be addressed through interdisciplinary experiences.
PREREQUISITES:
26920371 (FAMILY MEDICINE CORE CLKSP), 26931373 (INTERNAL MEDICINE CORE CLKSP), 26940373 (NEUROSCIENCE CORE CLKSP), 26946374 (OBSTETRICS/GYN CORE CLKSP), 26961373 (PEDIATRICS CORE CLKSP), 26963371 (PSYCHIATRY CORE CLKSP), 26980373 (SURGERY CORE CLKSP)

Student must be a 4th year medical student
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
NO
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO
COURSE LENGTH:
4 wks
DIRECTOR:
Anisasattara Shomo, MD
shomoaa@ucmail.uc.edu
(216) 533-4683
MSB, 4309
ADMINISTRATIVE SUPPORT PERSON:
Nancy Jamison
Nancy.Jamison@uc.edu
513-558-1435
MSB, 4304
SITE(S):
CCHMC - Cincinnati Children's Hospital
TriHealth Hospitals
UC Health West Chester Hospital
UCMC
MAX ENROLL:
2 
ROTATIONS:
Rotation Dates Max
1 05/06/2024 - 05/31/2024 1
2 06/03/2024 - 06/28/2024 1
3 07/01/2024 - 07/26/2024 1
4 07/29/2024 - 08/23/2024 0
5 08/26/2024 - 09/20/2024 3
6 09/23/2024 - 10/18/2024 2
7 10/21/2024 - 11/15/2024 2
8 11/18/2024 - 12/13/2024 1
9 12/16/2024 - 01/10/2025 0
10 01/13/2025 - 02/07/2025 3
11 02/10/2025 - 03/07/2025 3
12 03/10/2025 - 04/04/2025 1
13 04/07/2025 - 05/02/2025 1

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
8:00 am - 5:00 pm Monday-Friday
REPORT 1ST DAY:
You will receive an email with detailed information prior to the elective.

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Patient Presentation--Faculty
  • Patient Presentation--Learner
  • Research
  • Ward Rounds
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
50% Attending Physician
30% Other Allied Health Professional(s)
20% Independent study/reading
FEEDBACK:
ASSESSMENT:
  Institutionally designated evaluation

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Narrative Assessment
FINAL GRADE:
GRADE ASSIGNED BY: Course director

OBJECTIVES

Curricular Resources :
1)  Back, Anthony, Robert M. Arnold, and James A. Tulsky, Mastering Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope.  Cambridge, England, Cambridge UP, 2009
2)  Byrock, Ira.  The Four Things That Matter Most: 
a Book About Living.
New York: Free, 2004
3)  Wolfe, Joanne, Pamela S. Hinds, and Barbara M. Sourkes.  Textbook of Interdisciplinary Pediatric Palliative Care.  Philadelphia:  Elsevier/Saunders, 2011
4)  Emmanuel, Linda, Librach, S. Lawrence. Palliative Care:  Core Skills and Clinical Competencies.  Philadelphia: Elsevier/Saunders, 2011
Instructional Methods:
Clinical Experience - Inpatient
Knowledge/Skills:
1) Develop an understanding of palliative care and the role of hospice in dealing with patients with advanced disease, as well as the distinction between palliative care and hospice care.
2)  Experience both outpatient and inpatient roles of palliative and hospice care
3)  Be exposed to the interdisciplinary approach and the role of each person when caring for patients
4)  Learn the criteria for hospice and the available resources provided by hospice
5)  Develop an awareness of the psychosocial and spiritual needs of both the patient and family
6) Understand the role of life sustaining treatments such as feeding tubes, ventilator, and dialysis in treating patients near the end of life
7)  Learn how to manage common symptoms, including pain, nausea, fatigue, dyspnea, and delirium
8)  Develop an understanding of advanced care planning, including advanced directives, designation of power-of-attorney for health care, and long-term care options
Main Course Topics :
1)  Symptom management, including but not limited to:  pain, nausea, fatigue, delirium, dyspnea, anxiety
2)  Psychiatric issues regarding end of life
3)  Prognostication
4)  Palliative vs hospice care
5)  Advance directives vs. living will
6)  Bereavement
7)  Case based examples: conflict within the family, families unwilling to accept medical inevitabilities, specific spiritual desires
Procedures:
1)  Gather information from patients and families regarding their needs and wants for end of life care
2)  Follow 1-2 patients on the inpatient palliative care team and assist other members of the team in their care and providing the resources they need
3)  Become more confident in the delivery of bad news and discussing end of life issues with patients and families by participating in family meetings
4)  Observe and gain a better understanding of the role of home visits in hospice care
5)  Research a topic in palliative care of their choice and give a short presentation
Remediation Plan:
 To be determined on a case by case basis.

SAMPLE WEEK

Monday:
7:00AM 11:30AM Round with Palliative Care Team; or TBD
12:00PM 1:00PM Lunch
1:00PM 6:00PM TBD/TBA
Tuesday:
7:00AM 11:30AM Round with Palliative Care Team; or TBD
12:00PM 1:00PM Lunch
1:00PM 6:00PM TBD/TBA
Wednesday:
7:00AM 11:30AM Round with Palliative Care Team; or TBD
12:00PM 1:00PM Lunch
1:00PM 6:00PM TBD/TBA
Thursday:
7:00AM 11:30AM Round with Palliative Care Team; or TBD
12:00PM 1:00PM Lunch
1:00PM 6:00PM TBD/TBA
Friday:
7:00AM 11:30AM Round with Palliative Care Team; or TBD
12:00PM 1:00PM Lunch
1:00PM 6:00PM TBD/TBA
SCHEDULE NOTE:

Weekly schedule varies

ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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