Course Catalog

 
90-355 HOSPICE AND PALLIATIVE CARE ELECTIVE ROTATION
Department MEDICINE Campus Huntsville
Course Type(s) Elective Facility
Course Director ALAN BAGGETT, MD Enrollment Limit 2
Contact LANITA CARTER, PhD Enrollment Minimum 1
Email lanitacarter@uabmc.edu Address UAB Huntsville Regional Medical Campus
301 Governors Dr SW, Suite 313A
Huntsville, AL 35801
Phone (256) 551-4432 Fax (256) 551-4451
Weeks
Normally Offered
See Offering Dates		 1-2, 3-4, 5-6, 7-8, 9-10, 11-12, 13-14, 15-16, 18-19, 20-21, 22-23, 24-25, 28-29, 30-31, 32-33, 34-35, 36-37, 38-39, 40-41, 42-43, 45-46, 47-48, 49-50, 51-52
Prerequisites Completion of all Pre-Clinical Coursework 
Specific Clerkship Prerequisites:
Visiting Students
No LCME students accepted.
No osteopathic students accepted.
Course Description During this two week rotation, students will have the opportunity to work with and shadow the Huntsville Hospital Palliative Care Service and the Hospice Family Care Inpatient and Outpatient Services. During their inpatient palliative rotation (as available), students will observe, interview and interact with patients who are experiencing uncontrolled symptoms often related to a terminal disease process. Many are in a transitionary point between aggressive (quantity of life) management and palliative (quality of life) and so, the discussions at the bedside will provide very useful information and experience managing "goals of care." During the Hospice Family Care portion of this rotation, students will rotate with hospice RNs in the home/nursing facility (as available) setting, allowing students to see and assess patients in their typical environment. Students will also rotate with hospice social workers, our bereavement counselors, pharmacist and chaplain (as available). Learning Objectives: 1) Gain an appreciation of pain types (to include, somatic pain, visceral pain, neuropathic pain and psychosocial/emotional pain). 2) Observe and assess "Goals of Care discussions". 3) Gain comfort in opening these discussions at the bedside. 4) Become comfortable with the "CODE Discussion" - How to open, provide adequate informed consent on this topic. 5) Learn about the various prognostic tools used in palliative/hospice medicine to estimate life expectancy. 6) Gain knowledge on the use and utility of OME (oral morphine equivalency) in titration, transition and management of opioids in palliative and hospice medicine. 7) Gain an appreciation of alternative, non-opioid analgesics and anxiolytics (SSRI/SNRIs, TCAs, AEDs, Anti-spasmotics/muscle relaxors,
Where To Report TBD
Requirements Students will be expected to engage in patient interviews and physical examination, formulate plans of care, perform home/nursing facility visits, round at Huntsville Hospital and/or the Inpatient hospice facility. Additionally, students will be expected to meet with members of the hospice interdisciplinary team (as available) to gain an appreciation of the complexity of hospice care and services provided in this setting. This is an excellent opportunity to ask questions and familiarize yourself with the roles and responsibilities of hospice social workers, case managers, bereavement counselors and chaplains. At the end of the rotation, you will have a sit down interview with Dr. Baggett to review what you have learned and the experiences you have gained.
Evaluation Pass/Fail. The student will be evaluated by the attending physician based on observations of the student's performance, thought process, and interest level. They will be judged on knowledge, attitude, ability, level of documentation, communication skills, level of progressions , attendance, and timeliness. The rotation is pass or fail. The preceptor should give verbal and/or written feedback to the student approximately half way through the course and the student should feel free to ask for feedback more frequently.
Notes Co-Director: Roger Smalligan MD

General schedule of planned activities:

Students will spend one week of the two week rotation rounding with the Huntsville Hospital Palliative Care team. The second week will be spent shadowing and rounding with different members of the Hospice Interdisciplinary team at Hospice Family Care. Students will also shadow/round with the attending physician at the inpatient hospice facility.