An approach to educating residents about palliative care and clinical ethics

Despite interest in end-of-life educational efforts, attitudinal barriers still thwart the integration of palliative care into medical education. The authors present their experience introducing a graduate medical education program in ethics and palliative care at New York Presbyterian Hospital and Weill Medical College of Cornell University. Through this initiative the authors sought to enhance residents' knowledge, skills, and attitudes needed for effective palliative care. Residents were targeted because they are in a unique stage of their training; while they have mastered many basic clinical skills they remain open to educational experiences that might alter their lifelong practice patterns. Course material was based upon the residents' experiences. Using their case histories interested them as adult learners and validated the importance of the subject matter. Seminar themes included professionalism, the physician facing death, ethical, legal, cross-cultural, and religious issues at the end of life, and pain and symptom management. The program provided a valuable educational forum for residents to give voice to their reflections and receive supportive feedback from peers and faculty. Building upon the residents' own clinical experiences with end-of-life care effectively engaged their interest and provided much-needed instruction in this evolving area of study.