OU-HCOM expands end-of-life care training

Grant supports creation of palliative care program for third- and fourth-year students at CORE hospital sites

By Natalie Cammarata
Nov. 24, 2008

OU-HCOM will expand its end-of-life care education for third- and fourth-year students through a $30,000 education grant from the Palliative Care Education Project at the Medical College of Wisconsin (MCW). The grant will support clinical programs in palliative care—non-curative medicine focused on symptom relief and pain management for patients with chronic or terminal illnesses—at the various CORE (Centers for Osteopathic Research and Education) sites around the state.

OU-HCOM students currently complete a course
on palliative care before beginning their
third-year CORE rotations. Tracy Marx, D.O. (’92),assistant professor of family medicine, hopes the additional palliative care rotations will be up and running within two years and calls the development “a great next step” for end-of-life care training at OU-COM.

Marx, who is certified in palliative medicine and hospice—a program that provides comprehensive end-of-life care—says that efforts to bring palliative care programs to mainstream medical education are only recent, and OU-HCOM is quickly becoming a national leader in end-of-life care training. “For a long time, death and end-of-life care were
considered taboo,” Marx said. “When someone died, you didn’t talk
about it.”

End-of-life care training is required in all U.S. medical schools, as mandated by the Liaison Committee on Medical Education. Still, according to Marx, few schools have developed formal educational programs to fulfill that training requirement.

Marx’s passion for palliative care began during her residency at O’Bleness Memorial Hospital, a CORE affiliate. “There’s nothing more satisfying than helping someone live their last days. I certainly get more from my patients than I give to them,” said Marx, who now works closely with the Athens-based Appalachian Community Visiting Nurse Association, Hospice and Health Services, Inc., as their volunteer
medical director.

Judith Edinger, M.Ed., director of predoctoral education at OU-HCOM, said that palliative care training is vital to the future of medical students’ careers. “With our aging population, increasing students’ knowledge of palliative care is absolutely imperative.”

The Institute of Medicine estimates that, by 2030, the senior population (65 and older) will double from about one in ten Americans to roughly one in five.

Edinger and Marx will help to integrate palliative care into the clinical curriculum by working with CORE hospitals to implement the program as each site deems appropriate. Some hospitals may offer the training through an internal medicine department or geriatrics department, while others may add it to existing palliative care or hospice rotations.

The main challenge, according to Marx, will be standardizing the curriculum to create a uniform program across CORE sites despite different approaches to implementation.

The new program will give students experiential education, such as assisting during home visits and team meetings with hospice professionals, but also will incorporate relevant works in theater and film, echoing the college’s second-year curricular approach to palliative care. Marx said that through multimedia teaching methods, students can relate to a narrative, lending a more personal learning experience. In addition to class discussions and self-reflection, students also may engage in didactic online discussions with students from other CORE sites.

Marx said the program will help students approach end-of-life care “with dignity and grace.” Despite the discomfort often associated with death and dying, caring for people at the end of life is really a privilege, she said.