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Reaching out to your referring physicians Part I – Physician Education

Reaching out to your referring physicians Part I – Physician Education. David E. Weissman, MD End-of-Life Physician Education Resource Center (EPERC) Palliative Care Leadership Center Froedtert Hospital, Medical College of Wisconsin. Learning Objectives.

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Reaching out to your referring physicians Part I – Physician Education

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  1. Reaching out to your referring physiciansPart I – Physician Education David E. Weissman, MD End-of-Life Physician Education Resource Center (EPERC) Palliative Care Leadership Center Froedtert Hospital, Medical College of Wisconsin

  2. Learning Objectives • Learn the three educational topics most requested by physicians. • Learn three non-lecture strategies for providing physician education. • Discuss three ways to motivate physicians to learn about palliative care. • Develop three strategies to improve physician referral to palliative care clinical services. • Develop an Action Plan for physician education at your institution.

  3. Understand what you hope to achieve. • Education to improve patient care? • Increase referrals to Pall Care Program? • Decrease hospital costs? • Enhance institutional stature? • All the above?

  4. Understand the limitations of PC education • The goal of education is to change behaviors; but … • Most EOL education is geared toward knowledge … • Attitudes form the core of the problem, not knowledge deficits... • Attitudes resist change… • Learners must be ready to change.

  5. Why does education fail to change behavior? • Learner issues • Death-taboo subject, • Personal/professional failure • Ethical/legal misunderstandings • Confidence—Competence gap • Attitude domains trump knowledge • Change in medical practice • Loss of professionalism • Malpractice fears

  6. Education should make up only one aspect of “systems change” • Standards, guidelines, policies • Quality improvement based on standards of care • Education

  7. Educational Domains • Pain: assessment / treatment • Non-pain symptoms / syndromes • Communication skills • Ethics / law • Hospice / community resources • Terminal care / pt-family experience • Personal reflection

  8. Planning your teaching • Determine your audience. • Determine your learners’ tension points. • Write learning objectives. • Match objectives to teaching formats • Write a lesson plan

  9. Tension for Learning • Adult Learners--Need to know • Patient encounter—what do I do for X? • Testing • Fears • Malpractice • Ethical or Legal impropriety • Peer pressure

  10. Physician Needs Assessment • Ask them • what is difficult about caring for seriously ill patients and families? • Test them • a few brief questions to build tension for learning • Show them • demonstrate a difficult communication skill

  11. Most requested topics? • Dealing with families • Conflict • Futility • Time management • Pain/Symptom management

  12. Educational FormatsPlay the matching game! • Attitudes (feelings) • How does the situation make you feel? • Case study discussion • Role play • Knowledge (facts) • Lecture • Self-Study • Audio/Video tape • Test review

  13. Skills (doing something) • Demonstrate comm. Skill • Equianalgesic calculations • Care planning • Writing prescription

  14. Non-traditional learning formats • Test Review • Question by question • Role play with discussion • Real or simulated (videotape) • Discussion/Q &A/Practice • What’s hard … • Q&A • Skill Practice—Simulated cases • Writing orders

  15. Education as Marketing • All education should be used for marketing. • Link your education objectives to maximize your marketing message: • Dealing with conflict • Dealing with futility requests • Pain/Symptom management • Time management • Gather data for next program

  16. Keep it Simple • Simple handout • Pocket Cards: Pain, Family Conference template • Referral cards

  17. Resources • EPEC (www.epec.net) • UNIPACs (www.aahpm.org) • Powerpoint Presentations/CME (www.eperc.mcw.edu) • Fast Facts (www.eperc.mcw.edu) • Pocket Cards (www.mcw.edu/pallmed)

  18. Palliative Care Leadership Centers Medical College of Wisconsin Milwaukee, WI Fairview Health Services Minneapolis, MN Massey Cancer Center of the VCU Medical Center Richmond, VA Mount Carmel Health System Palliative Care Service Columbus, OH Palliative Care Center of the Bluegrass Lexington, KY University of California San Francisco, CA

  19. New Academic PCLC • Regular PCLC + • Academic mentoring • Academic education planning • Content specific to the AMC • MCW • UCSF • VCU Medical Center

  20. Design your next program • Who is your audience? • What is your specific topic? • Write 3 learning objectives/hour • Match objectives to formats • Write a Lesson Plan • Coordinate teaching materials • Time Line

  21. Write an Action Plan • What? • Who? • By When?

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