EPEC Workshop Modules
EPEC Workshop Modules
The Education for Physicians on End of Life Care workshop modules include the following elements:
Module 1 — Advance Care Planning
• Define advance care planning and explain its importance.
• Describe the steps of the advance care planning process.
• Describe the role of patient, proxy, physician,
and others.
• Distinguish between statutory and advisory
documents.
• Identify pitfalls and limitations in advance care planning.
• Utilize planning to help the patient put affairs in order.
Module 2 — Communicating Bad News
• Know why communication of "bad" news is
important.
• Understand the 6-step protocol for delivering "bad" news.
• Know what to do at each step.
Module 3 — Whole Patient Assessment
• Describe elements of suffering, including physical, psychological, social, and spiritual.
• Demonstrate ability to assess each.
Module 4 — Pain Management
• Compare and contrast nociceptive and neuropathic pain.
• Know steps of analgesic management.
• Know use of adjuvant analgesic agents.
• Know use of nonpharmacological approaches.
• Know adverse effects of analgesics and their
management.
Module 5 — Physician-Assisted Suicide (PAS)
• Identify root causes of suffering that prompt PAS or euthanasia requests.
• Define PAS and describe its current legal status.
• Explain key steps for responding to requests.
• Understand alternative strategies for addressing a patient's suffering and fears.
Module 6 — Anxiety, Delirium, Depression
• Identify major depression in patients facing the end of life.
• Distinguish major depression from normal reactions.
• Describe management plans for depression, anxiety, and delirium.
Module 7 — Goals of Care
• Name at least 5 potential goals of care that patients may have.
• Identify clinical junctures at which priorities should be clarified.
• Discuss how priorities should be determined.
• Know how to assist the patient to identify reasonable goals.
Module 8 — Sudden Illness
• Describe the features of sudden illness that require special skills.
• Know how to communicate effectively in the face of sudden illness.
• Know how to guide decision-making in the face of sudden illness.
• Explain the benefits and risks of using a time-limited trial approach.
Module 9 — Medical Futility
• List factors that might lead to futility situations.
• Know how to assist in resolving each factor.
Module 10 — Common Physical Symptoms
• Describe general guidelines for managing non-pain symptoms.
• Explain the impact of symptom control.
• Assess and treat each non-pain symptom.
• Explain how the principle of double-effect applies to symptom management.
Module 11 — Withholding/Withdrawing Treatment
• List medical orders relevant for terminally ill patients.
• Apply this knowledge to clinical situations.
• Describe common misconceptions about withholding or withdrawing therapy.
Module 12 — Last Hours of Living
• Prepare and support the patient, family, and caregivers (professional and volunteer) through the dying process.
• Assess and manage the pathophysiological changes of dying.
• Identify and manage initial grief reactions.
The Plenary modules cover the following:
Gaps in End-of-life Care
• Describe the current state of dying in America.
• Contrast this with the way people wish to die.
Legal Issues in End-of-life Care
• Describe legal consensus points.
• List common legal myths and pitfalls.
Elements of End-of-life Care
• Describe a conceptual framework for suffering.
• Describe the elements of end-of-life care.
• Define palliative care.
• Compare and contrast palliative care with hospice care.
Next Steps
• List the important themes from the conference.
• Identify barriers to good end-of-life care.
• Develop potential solutions.
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