Objective: To impart to medical trainees both the content and process of the behavioral, psychologic and spiritual issues surrounding dying persons and their families, as well as to arbite these issues at time of death.
Design: A description of the educational activities undertaken in the house staff training programs at our medical school to prepare future psychiatrists as well as future practitioners of other medical specialties in the understanding, sensitizing and undertaking of the medical care for the dying.
Materials and Methods: Description of our community, our curriculum, its written learning objectives and its learning activities, our sites of care, our faculty, our modes of pedagogy, and its means of evaluation
Results: The objective results of trainees knowledge of end of life care and its behavioral, psychologic and spiritual domains; the comments of the trainees upon completion of the learning experiences; the projects undertaken as a result of these learning experiences; and the comments of members of the clinical encounter sites and the overall community in which these experiences occur.
Conclusion: The 20th century paradigm of biopsychosocial domains of psychiatry might now be more globally construed, in at least one venue (that of care at the end of life), to include the spiritual and existential, as part of the conceptualization and formulation of the issues and forces operative for the dying person and her or his loved ones. This might thus connote a shift in the role the psychiatrist or other physician in that dyad in the time surrounding death for these parties. To empathically and experientially expose the physician trainee into this world, the world of dying, may then create for the trainee a richer training experience whose tents and teachings might perdurably extend to her or his other domains of learning, and with other patient populations. To do this with the requisite fidelity to dignity which these dying patients must be afforded thus requires the proper balance of clinical sites, faculty and ancillary health professional teaching and attention, yet also separate or parallel processing of the experiences engendered in a more supervisory setting for learner and teacher. the richness of learning that can come from such an organized experience however can be great, and is the focus of our end of life curriculum at LSU Shreveport.
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