Palliative Care Curriculum Overview

Educational Purposes and Goals

PGY 1:  Introduce the Palliative Care Consult Service while achieving the following goals

PGY 2:  Revisit the Palliative Care Consult Service while achieving the following goals

PGY 3:  Revisit the Palliative Care Consult Service while achieving the following goals

 

Knowledge: By the end of the rotation, the resident will be able to recall or describe the key evaluation and management concepts related to the following geriatric syndromes: 

  • Dementia
  • Urinary Incontinence
  • Depression
  • Management of Hypertension in the Older Adult
  • Falls
  • Delirium
  • The Hazards of Hospitalization for frail, older adults
  • Pressure Ulcers
  • Assessment of Physical Function
  • Polypharmacy
  • Advance Directives
  • Palliative Care
  • Assessment of Decision Making Capacity
  • Health Promotion and Disease Prevention

 

Attitudes: By the end of the rotation, the resident will gain a greater appreciation of the following concepts, as assessed by supervising attendings during their clinical interactions with patients:  

  • The importance of individualized decision making,  reflecting the heterogeneity found among older persons with respect to physiologic function, health status, belief systems, values and personal preferences
  • The importance of negotiating goals of care with the patient and family and take into consideration both the individual’s values and preferences as well as the physician’s professional judgment.
  • The importance of seeking out and consider the observations and opinions of family and other concerned individuals in evaluating an older patient and bear in mind that the primary obligation is always to the patient.
  • The function and importance of a multidisciplinary approach to caring for older persons, including appropriate respect for other health professionals and paraprofessionals and their roles in the provision of services.
  • The resident must understand that maintenance of function and quality of life are more often goals of care than cures of disease.

Skills: By the end of the rotation, the resident will demonstrate competency through direct observation in the following skills

  • The ability to perform screening assessments of basic and Instrumental Activities of Daily Living (ADL and IADL), cognitive function, and gait and mobility. 
  • The ability to facilitate medical decision-making for elderly patients, incorporating medical assessment as well as patient values and preferences. The resident should display respect for elderly patients and effective communication skills.
  • The ability to diagnose and manage acute and chronic multiple illnesses in elderly patients.
  • The ability to coordinate care of patients between ambulatory settings and long-term care, including home care, nursing homes, and hospice care.
  • The ability to effectively conduct discussions regarding goals of care and end-of-life care.
  • The ability to ask a focused clinical question and to use the techniques of evidence based medicine to find the answer.
  • The ability to compose a Critically Appraised Topic in Geriatric Medicine.

 

II. Sites of Care & Supervision of Residents

  1. University of Chicago Clinics    
  2. Ambulatory Care Sites:

Residents care for teaching patients in the ambulatory care setting at the following University of Chicago Geriatric Clinics:

The Outpatient Senior Health Center at South Shore

 7101 S Exchange St.

Chicago, IL  60649

Supervision: Each resident is directly supervised in a 1:1 fashion by a Board Certified Geriatrics Faculty Member of the University of Chicago’s Department of Medicine, Section of Geriatrics.  In each ½-day clinical session, the resident will see approximately 4 patients scheduled no more often than every 30-minutes.

 

  1. Affiliated Clinical Sites
  2. Nursing Home Sites

The residents care for teaching patients at the following affiliated nursing home sites   

                 

  1. The Renaissance Nursing Home

    2425 East 71st Street

    Chicago, IL  60649

 

Supervision: Each resident is directly supervised by a Board Certified Geriatrics Faculty Member of the University of Chicago’s Department of Medicine, Section of Geriatrics.  The Medical Director of each of these nursing homes is a member of the University of Chicago’s Geriatrics Faculty. 

 

 

  1. Evaluation of Residents during the Geriatrics Rotation

 

  • Didactic Component (25%)
    • The residents receive a series of lectures during the geriatrics rotation.  These lectures cover core topics in ambulatory geriatric medicine. The lectures are delivered in ½-day sessions, with three 50 minute lectures per ½ day lecture session.
  • Clinical Component (65%)
    • Ambulatory Geriatric Medicine
      • Residents provide care to adults 65 and over who are being seen both for routine medical visits and urgent care visits
          • South Shore Senior Health Center
  • Nursing Home Care
    • Residents receive an introduction to nursing home care and provide care to patients institutionalized in these two University of Chicago affiliated Nursing Homes
          • The Renaissance Nursing Home
  1. Evaluation of Geriatrics Rotation

Each resident is asked to complete a quantitative survey designed to assess specific components of the geriatrics rotation.  In addition, a geriatrics staff member trained in qualitative interviewing conducts an exit interview with each resident at the end of the rotation.