Abstract:

Objective:
Learn how a Palliative/Long-Term Care (LTC) course was introduced into a professional curriculum to provide students with didactic and clinical experience to improve care for persons with chronic illness and disabilities. Share implementation/ adaptation tips, resources, solutions to potential pitfalls, and samples of the curriculum.

Rationale:
Medical advances have allowed persons with chronic conditions and disabilities to live longer. The 2009 US Census projects that by 2030 nearly one in five US residents will be 65 and older. Other countries also are experiencing an increasingly aging population. Clinical, Public Health, and Administration programs will have an increased need to provide additional knowledge and skills for their students. The George Washington University Physician Assistant faculty identified a new clinical requirement as an opportunity to revise their curriculum to provide didactic and clinical training, across the age span, in Palliative and LTC.

Methodology:
Year One: Survey existing inpatient and psychiatry training sites to quantify LTC patients, add new pediatric and geriatric LTC training sites, pilot a one week clinical rotation with selected students and sites, including three written reflection exercises, written case presentation, and an end-of-rotation (EOR) examination.
Year Two: Identify additional training sites, initiate a one week clinical LTC rotation within existing rotations, including three written reflection exercises, written case presentation, and EOR examination.
Year Three: Initiate a separate Palliative/LTC rotation for all students, comprised of a two week online distance didactic phase, including daily assignments, collaborative activities, group discussions, and three written reflection exercises, followed by a two week clinical phase at either a pediatric or geriatric LTC site.

Evaluation:
Site preceptors have been surveyed about student knowledge and preparation for the rotation. Students have been surveyed about the effectiveness of the didactic content to prepare them for their clinical rotations.

Results:
Faculty preceptors reported students were well prepared for site participation and duties and that the students add a valuable dimension to the site. Most students felt the didactic material provided good preparation for the clinical experience and that both have been useful for other rotations. Student recommendations included consolidation of the online portion to allow a one week didactic and three week clinical format.

Conclusions: This curriculum model, with a participatory distance education phase followed by a clinical phase in either an adult or pediatric site, offers an efficient, adaptable, and replicable method to meet curriculum requirements, while preparing students in multiple fields for the increasing need for LTC and Palliative Care skills and experience. Continued improvement will be undertaken in view of the feedback from students.

Keywords:

Palliative Care Training, Long-Term Care Training.