Recommendations for incorporating palliative care education into the acutecare hospital setting

This article presents recommendations for improving the education of physic ians about end-of-life care in the acute care hospital setting. The authors , who have a variety of backgrounds and represent several types of institut ions, formulated and reached consensus on these recommendations as members, of the Acute Care Hospital Working Group, one of eight working groups conve ned at the National Consensus Conference on Medical Education for Care Near the End of Life in May 1997. A recently published literature review on the status of palliative:care education, a summary of recent research on educa tion about end-of-life care, and expert opinion were helpful in developing the recommendations. The authors emphasize that the acute care setting offers many opportunities for education about care at the end of life. Faculty should support learne rs'. appreciation of the importance of end-of-life care, and convey the mea ning and privilege of attending to patients and families lies at this dific ult time. Faculty should teach students and residents to provide care that embodies attention;to the control of distressing physical, physiologic and spiritual symptoms, appropriate awareness of patients' differing cultural b ackgrounds and their impact upon the experience of dying, excellent communi cation skills, the application of bioethical principles, timely referral an d smooth transition to other care settings that meet patient and family goa ls, and the role of the interdisciplinary team in meeting the diverse needs of dying patients their families.