The Portal of Geriatrics Online Education

Palliative and End of Life Care

Palliative Care of a Patient with End-Stage Liver Disease: An Unfolding Case Study

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Estimated time to complete: 
2
Abstract: 

This case study was developed for use in academic coursework and as a standalone training for health care providers (MDs, ARNP, Pharmacists, Social Workers, Nurses). This unfolding case study about the management of an adult in the midst of a health crisis. This case is a composite of many actual cases seen in clinical practice. During the course of this case study, learners are presented with information as the providers learn of the patient’s emergent and ongoing health concerns – from his Emergency Department admission through the development of his palliative care plan. Learners are asked to make decisions and use their best judgment about how to care for this patient and family.

Educational objectives: 

By the end of this case study, the learner will be better able to:

  1. Understand the natural history and disease management of end stage liver disease (ESLD).
  2. Use evidence-based practice to collaboratively develop and refine goals of care for patients with chronic, progressive conditions.
  3. Work interprofessionally to ensure the best quality of care for the patient and family.
Date posted: 
Fri, 09/14/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 08/15/2018
Contact Person/Corresponding Author:



Suggested Citation:
Palliative Care of a Patient with End-Stage Liver Disease: An Unfolding Case Study. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/4828

Simulation Curriculum for Geriatric Medicine Fellows

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
999
Abstract: 

This material consists of a suite of nine simulated clinical cases, divided into three separate sessions of three cases each, intended to be conducted in a simulation center with simulated patients.  Cases are designed to teach geriatric medicine fellows and other appropriate learners basic geriatric assessment skills (Session one), how to navigate difficult situations in long-term care (Session two), and high-level communication skills in palliative and end-of-life care (Session three).  Each case consists of a multi-page document outlining scripts for the learner as well as the roles (patient, family member, facility staff, etc) portrayed by actors, necessary props and supporting materials, and instructions for evaluating and debriefing the learner.  Also contained in each document are Entrustable Professional Activities (EPA), Curricular Milestones (CM), and Reporting Milestones (RM) relevant to the case.

Educational objectives: 

- Efficiently and effectively assess and manage common geriatric syndromes in a variety of clinical settings.

- Demonstrate the ability to navigate difficult communication scenarios in a long-term care environment, while providing leadership, mediating conflict between interdisciplinary team members and/or family members, and providing high quality care.

- Provide compassionsate, patient-centered care at the end of life, using high-level communication strategies.

Additional information/Special implementation requirements or guidelines: 

n/a

Publications from, presentations from, and/or citations to this product: 

None, though plans to present this at AGS/ADGAP in 2019.

Date posted: 
Mon, 11/12/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 08/08/2018
Contact Person/Corresponding Author:



Suggested Citation:
Simulation Curriculum for Geriatric Medicine Fellows. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/4828

Advance Care Planning

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
2
Abstract: 

The Advance Care Planning Module uses a team approach to reduce errors and improve the quality of health care for older adults. This interdisciplinary formative assessment tool for Elder Safety can be utilized by fourth-year medical students, residents in training and practicing physicians. Learners will take a pre-test, review learning objectives, exemplar and video demonstrations, have access to reference materials and links to websites for Advance Care Planning. Content experts share their professional experience on the sensitive topic of addressing patient goals of care in preparation for death and dying.  Information on Advance Directives, legal considerations, clinician resources, cultural and gender differences, patient competency and capacity concerns are presented in a straight forward way to aid the medical professional in their ability to facilitate end-of-life care.  

Educational objectives: 

1. Healthcare professionals working with the 65 years and older population will develop knowledge and skills needed to formulate a health policy and educate patients about an Advance Care Plan.

2. Healthcare professionals working with the 65 year and older population will gain an advanced understanding of the options available to patients when planning end-of-life care.

Additional information/Special implementation requirements or guidelines: 

To access the material, go to the Learning Center at ilearn.nbome.org to access the Elder Safety Modules:

  • Select your learning activity (Advance Care Plan) and add it to your cart.
  • In the cart, click Proceed to Checkout. This will prompt you to either create a new account or login to your existing one.
  • Create your free account by entering the required information.
  • Once completed you will be directed back to the catalog to complete your course registration.
  • There is No Charge for viewing the Advance Care Plan Module.
Publications from, presentations from, and/or citations to this product: 

Presentation:

Marquez-Hall, S., Horber, D. (2017) Web-based formative assessment: An innovative way to assess and improve physician/patient care using an interprofessional team approach. Joint presentation with the National Board of Osteopathic Medical Examiners at the American Association of Osteopathic Medicine and Association of Osteopathic Directors and Medical Educators Annual Conference, Baltimore, MD

Date posted: 
Fri, 01/12/2018
Product Viewing Instructions: 
See Additional information/Special implementation requirements or guidelines under the Additional Details Section.
Contact Person/Corresponding Author:



Suggested Citation:
Advance Care Planning. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/4828

Establishing goals of care- Standardized caregiver interview

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Estimated time to complete: 
1
Abstract: 

This Observed Standardized Caregiver (SCG) interview is designed to be used with geriatric fellows. The goal is to assess the fellow's competence in establishing goals of care with patient’s families in the ambulatory setting. 

Educational objectives: 

The case is designed to evaluate geriatric fellow’s ability to elicit the following core competencies in geriatrics assessment during a Standardized Patient Interview:
1. Establish that the caregiver is the appropriate health care designee
2. Introduce the need to have a discussion about overall goals of care
3. Establish what would be an acceptable quality of life for the patient
4. Assist the family with completing a written health care directive ( for this exercise a Practitioner Order of Life Sustaining Treatment  form - POLST )
 

Additional information/Special implementation requirements or guidelines: 


This exercise can be integrated into an ongoing geriatrics curriculum for geriatric fellows.
• An overview of the educational goals and patient characteristics is discussed with the fellow(s) prior to the session (15 minutes)
• Training of SCG (30 minutes)
• The fellow(s) are videotaped performing a caregiver interview (30 minutes)
• The fellow(s)complete a self-assessment tool (3 minutes)
• The SCG completes a fellow(s) assessment tool (3 minutes)
• The videotape is reviewed by the faculty with a standardized assessment tool (20 minutes)
• A group session to provide formative feedback is conducted with geriatrics faculty
 

Date posted: 
Thu, 11/16/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 11/01/2017
Contact Person/Corresponding Author:



Suggested Citation:
Establishing goals of care- Standardized caregiver interview. POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/4828

Advance Directives

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

Advance Care Planning (ACP) is more than documenting life-sustaining treatment choices or identifying a surrogate decision-maker; it is a comprehensive, continuing communication and ‘shared decision-making’ process between the patient, family, and medical providers designed to document patient values and goals for treatment.

This interactive self- learning module is designed for undergraduate medical students with the goal of introducing learners to ACP while building their confidence in facilitating difficult conversations with patients. At the beginning of the module, we provide background on ACP including the challenges and benefits associated with the process. We showcase an elderly couple discussing how important it is to have advance directives in place. The second portion of the module reviews the common forms that are used to document advance directives and two patient case scenarios where the students can interact and reflect on the acquired content.

Educational objectives: 
  • Recognize the relevance in conducting and documenting advance directive discussions with patients.
  • List commonly used advance directives documents.
  • Develop the skills necessary to engage patients in a discussion about advance directives through the use of realistic patient case scenarios.
     
Date posted: 
Wed, 07/19/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sun, 07/19/2020
Product Viewing Instructions: 
Interactive self learning module
Contact Person/Corresponding Author:



Suggested Citation:
Advance Directives. POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/4828

Goals of Care/Medication Management Clinical Evaluation Exercise (Mini-CEX)

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This goals of care and/or medication management Clinical Evaluation Exercise (Mini-CEX) is designed to use with a learner during a patient encounter. The teacher observes the learner with a patient discussing goals of care and/or medication managment and completes the form. The teacher then reviews the form with the learner and provides feedback of what skills were observed, partially observed, not observed, not applicable and comments about the encounter.

Educational objectives: 

Learners who are administered this Goals of Care/Medication Management Mini-CEX will:
1)be observed discussing goals of care and medication management with their patients and families.
2)receive feedback about their communication skills with patients and families.
3)obtain record of their goals of care and/or medication managment assessment skills using a Mini-CEX.

Date posted: 
Mon, 01/23/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 01/23/2017
Contact Person/Corresponding Author:



Suggested Citation:
Goals of Care/Medication Management Clinical Evaluation Exercise (Mini-CEX). POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/4828

Advance Care Planning and POLST Conversation Guide

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
3
Abstract: 

This is an educational product to teach health care providers how to conduct goals of care conversations with patients and caregivers

Educational objectives: 

1. Recognize and respond to emotional cues during challening conversations  2. Demonstrate how to elicit patient perception of illness and goals of care 3. make a recommendation about code status based on patient's goals 4. Provided a basic description of CPR avoiding medical jardon 5. Discuss possible outcomes of CPR including survival percentages and possible risks.

 

Date posted: 
Mon, 10/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
Advance Care Planning and POLST Conversation Guide. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/4828

Interdisciplinary Health Profession Module Videos

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

Care teams often don't know how to effectively and efficiently collaborate when addressing a patient’s health. Depending on a patient’s needs, team leadership can shift at any given moment from one person to another. Because of this constant jockeying and adaptation, educating learners about their own interprofessional relationships is becoming incredibly important. These videos and the corresponding text supplements provide a context for interprofessional team members to discover more about what it takes to become a member of another profession. This knowledge, combined with their own experiences and clinical practice, will assist in preparing learners for the next-generation of team-based healthcare.

Educational objectives: 

After watching these short 2-3 minute videos, interprofessional teams will be able to contextualize their own relationship within the group dynamic, understand the educational requirements that go into other disciplines, and formulate an effective team-based learning approach for future activities.

Date posted: 
Tue, 09/27/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/27/2016
Contact Person/Corresponding Author:



Suggested Citation:
Interdisciplinary Health Profession Module Videos. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/4828

The Geriatric Experience Multimedia Menu for Residents and Medical Students on Geriatrics Rotation

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
3
Abstract: 

This multimedia menu was created to add variety to a geriatrics rotation for third- and fourth-year medical students and family medicine residents while exposing learners to different aspects of the social and ethical issues integral to the care for older adults. The menu includes multiple books, movies, online videos and podcasts that learners may choose from during an assigned half-day of the rotation. Afterward, learners complete a written, personal reflection that is submitted to the course director. Reflective ability is an important skill for practicing physicians that is rarely taught in a formal curriculum. This simple menu broadens the breadth of the geriatric rotation and creates an opportunity to practice reflection. 

Educational objectives: 

After completing this experience, learners will:

1. Critically reflect on clinical experiences through the lens of multimedia portrayals of issues related to older adults. 

2. Discuss ethical issues related to the care of older adults. 

3. Describe new insights from a variety of media types and apply these insights to future practice. 

Date posted: 
Wed, 10/05/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/05/2016
Contact Person/Corresponding Author:



Suggested Citation:
The Geriatric Experience Multimedia Menu for Residents and Medical Students on Geriatrics Rotation. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/4828

Building Caregiver Partnerships Through Interprofessional Education

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

Family caregivers are on the frontlines managing complicated chronic illnesses, assisting with day-to-day functioning, and providing direct care to manage symptoms and improve the quality of life of their loved ones. Yet, health professions students, medical/surgical residents, and care providers receive little, if any, training on the vital role that caregivers play on the healthcare team and how, effective partnering optimizes patient care throughout the illness trajectory and at end-of life.

The goal of Building Caregiver Partnerships through Innovative Interprofessional Education is to create effective partnerships between healthcare providers and family caregivers to reduce the burdens, ease suffering, and enhance the meaning of the caregiving experience for the patient, family and health care providers.  The project centers on a 20-minute film, No Roadmap: Caregiver Journeys, which features the compelling stories of four caregiving families. The film and companion discussion guides as well as resources for case-based learning and structured clinical encounters are freely accessible on the website. http://www.neomed.edu/medicine/palliativecare/building-caregiver-partnerships/

The website is designed so that faculty can easily select the materials that best fit their learners’ needs and the time constraints within their programs. The curricula is appropriate for medical, pharmacy, nursing, and other health professions educational programs at both undergraduate and graduate levels. Additionally, tools have been developed for interdisciplinary team-based forums and health provider training.  For medical/surgical residency programs, relevant ACGME milestones are identified. 

Educational objectives: 

The objectives of the educational tools are to prepare learners to:
• Describe home-based eldercare as a shared experience and the importance of building a relationship with family caregivers and care recipients based on trust, compassion and open communication; 
• Describe the vital role of family caregivers as important, but under recognized, members of the health care team;
• Discuss the meaning and challenges of family caregiving;
• Engage caregivers in meaningful discussions to identify the needs, values and goals of their caregiving family;
• Identify resources to address caregiver concerns and provide ongoing support; and
• Provide holistic team-based care to family caregivers that improves the quality of life for the care recipient and the caregivers. 

 

Publications from, presentations from, and/or citations to this product: 

~~Date/Location Meeting/Forum Presentation Title Presenter(s)
Jan 28-31, 2016, Phoenix, Arizona; Society of Teachers of Family Medicine; 45 min presentation;  Exploring Caregiver Journeys: A Curricular Tool for Family Medicine Clerks;  D. Sperling; J.T. Thomas

March 10-13, 2016; Chicago, Ill;  American Academy of Hospice and Palliative Medicine;  60-min workshop; Using Film to Foster Empathetic Partnerships between Care Providers and Family Caregivers;  J. Drost; E. Scott; M. Scott; D. Damore; S. Radwany

May 19-21, 2016; Long Beach, Ca; American Geriatrics Society; Poster; Building Caregiver Partnerships Through Innovative Health Professions Education; E. Scott, S. Radwany, D. Drost, K. Baughman, B. Palmisano, M. Sanders

May 19-21, 2016; Long Beach, Ca; American Geriatrics Society; Educational Product Session; Building Caregiver Partnership Through Innovative Health Professions Education; J. Drost; B. Palmisano

May 25, 2016; NEOMED Department of Family and Community Medicine Resident Scholarship Day; 15 min presentation; Exploring Caregiver Journeys: A Curricular Tool for Family Medicine Residents; D. Sperling; J.T. Thomas
 

Date posted: 
Mon, 12/12/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 05/19/2017
Contact Person/Corresponding Author:



Suggested Citation:
Building Caregiver Partnerships Through Interprofessional Education. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/4828

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