University Times

The School of Medicine has received a $750,000 grant from the National Cancer Institute to integrate end-of-life issues into the school's curriculum so that medical students can better learn how to care for dying patients and their families.

David Barnard, professor of medicine and director of Palliative Care Education at the Center for Bioethics and Health Law, said: "Physicians find caring for dying patients stressful, and their own attitudes toward emotional or psychosocial aspects of such care contribute to their avoidance of these issues. Physicians often report feelings of sadness, helplessness, failure, disappointment and loneliness when dealing with end-of-life patients."

Nearly 2.5 million Americans die each year. Research has shown that many dying patients and their families suffer needlessly because physicians are not adequately trained to care for people who are dying. According to Barnard, curriculum changes can improve physician attitudes and knowledge related to end-of-life care.

The goals of the new curriculum are:

* To increase students' exposure to the scientific and humanistic knowledge necessary for excellent end-of-life care;

* To develop and implement learning experiences that provide students with prolonged exposure to dying patients, and

* To increase the number of faculty who have completed programs to improve their skills in teaching end-of-life care to medical students.

"Physicians, patients and families often find it difficult to talk about preferences for treatment near the end of life and to respect those preferences," said Robert Arnold, the Dr. Leo H. Criep Professor in Patient Care and director of the UPMC Comprehensive Palliative Care Program. "Medical schools have not spent much time on the management of pain and other common symptoms at the end of life or attending to psychological, spiritual and existential concerns of patients. Our primary goal is a four-year medical school program in which each year makes the optimal, appropriate contribution to effective and compassionate care of patients near the end of life."

Curriculum changes will be phased in over several years. A course beginning this fall will allow students to visit critically ill and dying patients at home.

"With these in-home visits, students will learn directly from patients and their families what it is like to have a life-threatening illness, and it will help the students to develop skills in listening to patients about the impact of illness on life," Barnard said.