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Interdisciplinary education seeks to improve palliative care

LOUISVILLE, Ky. - A unique curriculum at the University of Louisville is preparing medical, nursing, social work and pastoral care students to work together on interdisciplinary teams, so patients can receive better care when facing a serious illness.

The program, interdisciplinary curriculum for oncology palliative education (iCOPE), piloted in Fall 2012, and is teaching students to distinguish the roles and contributions of each team member; equipping them to initiate an interdisciplinary collaboration; and helping them to formulate a patient care plan that addresses psycho-social-spiritual and physical needs. The curriculum is mandatory for nursing students, master's level social work students specializing in oncology social work and clinical pastoral care trainees. It will be required for medical students starting in Fall 2013.

Alyssa Compton, a UofL School of Nursing alumna, works as a registered nurse on the neuroscience intensive care unit at University of Louisville Hospital (ULH). She was part of the first iCOPE class.

"iCOPE helped me understand how each discipline thinks in response to a patient's condition. I saw how important this team is to families who see their loved one from a holistic view point and are looking to the team for guidance to get them through," Compton said.

The curriculum planning began when UofL received a five-year $1.5 million grant in 2010 from the National Institutes of Health to develop, implement and evaluate an interdisciplinary oncology palliative care education program.

Mark Pfeifer, MD, professor of medicine, UofL Division of General Internal Medicine, Palliative Medicine and Medical Education, is the principal investigator on the project.

"Palliative care is much more than end-of-life care," said Pfeifer, who also is senior vice president and chief medical officer for ULH. "It focuses on ongoing quality of life and well-being and is integral to the treatment of cancer patients from time of diagnosis throughout the trajectory of the illness."

"Students often are educated in silos and have no idea how to work together in professional teams, and this is why we don't always provide appropriate care for patients and their families," said Carla Hermann, PhD, RN, project co-investigator and UofL School of Nursing professor. "What we have developed is what we believe to be an ideal model, not just for palliative care, but for many areas in the health professions."

The curriculum includes three components: on-line case-based learning designed to teach students core concepts of palliative care, interdisciplinary case management experiences (ICME) and clinical experiences that include a reflective writing exercise.

The web-based modules include topics related to roles of each team member, pain and symptom management, communication, spiritual dimensions of care, and grief and loss. Each module integrates core concepts when providing care to a particular patient. The on-line segments were created in an interactive software program that link to videos, websites and learning activities.

During the ICME session, teams of students from each of the four disciplines meet to consider a patient case, share information and develop a care plan based on simulated interactions between a patient, family members and treatment team members. The final step in the iCOPE course places students in clinical settings where they observe the care of a patient with a serious illness and write a paper evaluating the care and how it may have impacted them personally. Students from each discipline share and discuss their experiences in small groups.

"Our goal is to graduate students who create the demand for these interdisciplinary teams because they have learned the value of what other professionals can bring to the table as it relates to patient care," Pfeifer said.

Pfeifer hopes the program eventually will be transportable to other colleges and universities.

The iCOPE team will continue to evaluate the program and make adjustments through the end of the grant period, 2015.


Contact: Julie Heflin
University of Louisville

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