The curriculum is built upon an interplay of didactic activities, personal development, interprofessional team work, and clinical Rotations. Below is a description of each.
Palliative Care Didactic Sessions, including Lunch & Learns, and University of Alaska Anchorage, ECHO
This occurs every Tuesday (except the week of Journal Club) at noon throughout the fellowship year. This is an hour of dedicated evidence-based lectures and conversations based in the foundational educational needs of hospice and palliative fellows. The topics include communication tools, symptom management, resiliency activities, cultural humility, spiritual care, and more. Faculty and guest speakers conduct the majority of lectures with each fellow conducting two sessions to provide fellows the ability to practice adult learning principles necessary to be a specialist hospice and palliative leader.
This occurs once a month on the 3rd Tuesday of the month and it replaces the Didactic Series for that week. This is a discussion (not presentation) about a research article germane to hospice and palliative care. Sometimes these are foundational studies that all hospice and palliative specialists should have knowledge about, or sometimes it is new research with the focus on the credibility, reliability, and adaptability of the research to current practice. Each fellow conducts one to two journal club sessions per year.
Ethics Education & Training
“Lunch Bunch Ethics Conversations” is an informal, weekly, hour-long conversation about ethics in healthcare. Lunch bunch is an opportunity to explore current topics and issues, discuss recent journal articles, and provide current and past clinical ethics case consultation services for the hospital. Our institution also boasts a “Caregiver Cafe” and “Ethics Forum” that alternate every other month. The “Caregiver Cafe” has a mission to “build emotional health and resilience in our clinical practice through case review.” The Ethics Forum is an open forum to discuss contemporary ethical issues in health care. Our Regional Ethics Director presents at the Palliative Care Lunch & Learn on various topics such as but not restricted to the principles and methods of moral reasoning in clinical ethics. The expected ethics focused outcomes for the fellows include:
- Introduce and develop ability to engage clinical ethics methods of reasoning
- Introduce and involve fellows in clinical ethics consultation case discernment and review
- Expose and encourage involvement in hospital-based, monthly ethics forums and caregiver resilience sessions
Clinical Pastoral Education Didactic
One time during the fellowship year each fellow presents a didactic session to the Clinical Pastoral Education interns and residents. This topic is decided upon in conversation with the Manager of this program along with input from the Hospice and Palliative Medicine Fellowship faculty.
Palliative care requires pro-active personal self-care and our fellowship encourages and fosters this. Each day, our team meetings begin with a reflection and often time, a common theme is about personal wellness and coping. This practice helps create a culture of self-care and compassion. We have clear coverage protocols and design patient care to be provided by a team to promote safe care transitions and allow the fellow to be “away” from the hospital while feeling confident their patients still receive the best care possible. This structure of patient care elicits trust and a deep respect for each caregivers time away as being important for well-being not only for that caregiver, but for the team. Lastly, this fellowship boasts a Wellness Rotation focused on personal development of resiliency and self-care skills.
Interprofessional team work
The Palliative care department, including both inpatient and outpatient teams, is a robust inteprofessional team with 4 physicians, 6 nurse practitioners, 2 social workers, 1 registered nurse, 1 certified medical assistant, 1 profesional support specialist and our Fellowship Coordinator, Stephanie Harpel; our department also works closely with the Providence Alaska Medical Center spiritual care department. Along with professional colleagues, we host medical, advanced nursing, physician assistant, and other healthcare students allowing the fellows the ability to learn alongside and share their knowledge with other healthcare students. HPM Fellows precept and work closely with all types of healthcare professionals, and this is further supported by daily interprofessional team meetings to discuss the care of patients & families dealing with serious illness.
The Fellow works with our HPM Fellowship Director to define, execute, and report on a scholarly endeavor. Predominantly, the scholarly endeavors have followed a quality improvement framework, but effort is made to help each fellow identify a meaningful project that supports their professional role development.
The Providence Medical Group Palliative Care Department is a strong interprofessional team composed of physician and non-physician faculty. Clinical supervision of our fellows occurs through a mix of physician and non-physician faculty and progresses along a trajectory leading towards independent specialty practice. Physician faculty, including the HPM Fellowship Director, Palliative physicians, and non-Palliative physicians, provide clinical education, as well as, professional and role development mentorship. Non-physician faculty, including the Interprofessional Education Director, also provide clinical education along with supporting the fellows’ development of teamwork, communication, collaboration, and understanding the values, ethics, and thought paradigms that guide each professions’ practice. Our faculty engage in a wide-range of educational offerings to build respect, foster humility, and strengthen advance communication techniques to promote fellow learning, resilience, and confidence.
Controlled Substance Stewardship
The Palliative Care leaders of the future need to have the knowledge, skills, and abilities to screen, manage, and educate patients, families, the community, and their colleagues about medically appropriate use of controlled substances for the seriously ill. To support their growth, a Controlled Substance Stewardship program for the seriously ill was developed. A 3 hour interactive session reviews pain pathophysiology and pharmacology, medically responsible controlled substance prescribing practices, opiate screening tools, relevant organizational policies and procedures, equianalgesic conversions, and the use of the Alaska Prescription Drug Monitoring Program (AK PDMP). During community based palliative care rotations, they are taught and use the Opioid Risk Tool and opioid contracts. Fellows also participate in a rotation with a local interventional pain specialist, along with didactics specific to opioid prescribing, assessing substance use disorder history, and the treatment of substance use disorder and a focused on multi-modal pain management.
Please see Rotations page for a breakdown of clinical rotations and possible electives.