Jennifer Healy

Do Symptoms Matter When Considering Patients for Phase I Clinical Trials? A Pilot Study of Older Adults With Advanced Cancer

Background: Older adults (OA) with advanced cancer (AC) undergoing phase I clinical trials (PICT) have poor prognosis. There are no studies which describe symptoms experienced by OA. Methods: Retrospective chart review of PICT participants >60 years. OA were compared by age (>65 vs 60-65) and by number of symptoms (>3 vs ≤3). Results: N = 56. Mean age = 67.09; 48.21% female. Median life-expectancy = 5 months (interquartile range = 2-9 months); 80.36% had pain; of those 64% without pain scale. Most did not have interdisciplinary professionals or hospice referrals. Older adults with >3 symptoms had more admissions (37.5% vs 14.29%; P = .0335), complications (46.43% vs 16.07%; P = .0026), and greater decline in functional status (24 participants >3 symptoms vs 8; P = .0173). There were no significant differences comparing OA by age. Conclusions: Older adults enrolled in PICT with more symptoms may sacrifice QOL for experimental treatment.

Communicating With Dying Patients and Their Families: Multimedia Training in End-of-Life Care:

Background: The need for end-of-life (EOL), high-impact education initiatives to prepare medical students to communicate with dying patients and their families and to cope with issues of death and dying, is well recognized. Methods: Third-year medical students (n = 224), during their ambulatory rotation, completed a multimedia EOL curriculum, which included pre-/posttests, an online case-based module, didactic presentation, and a tablet computer application designed to demonstrate the signs and symptoms seen in the last hours of life for families of dying patients. Pre- and posttests were compared using Pearson χ2 or Fisher exact test, and improvement was measured by weighted κ coefficient. Results: On preintervention surveys, the majority of students demonstrated positive attitudes toward the care of dying patients and their families. Despite this high pretest positive attitude, there was a statistically significant overall positive attitude change after the intervention. The lowest pretest positive attitudes and lowest posttest positive attitude shifts, although all statistically improved, involved addressing the thoughts and feelings of dying patients and in coping with their own emotional response. Conclusions: Medical students exposure to this multimedia EOL curriculum increases positive attitudes in caring for dying patients and their families.

The Double Parallel Curriculum in Palliative Care: Teaching Learners to Teach End-of-Life Care at the Bedside:

Context: Dying is a natural process, yet physicians are often uncomfortable caring for dying patients. Learners have limited exposure to curriculum on caring for dying patients and often navigate these encounters without appropriate skills and confidence. We developed and implemented the Double Parallel Curriculum in Palliative Care (DP-PC): End-of-Life (EOL) module. The DP-PC focuses on teaching third-year medical students (MS3) to not only take care of patients in their last hours of life but give learners the confidence to teach patient’s families what to expect as they hold vigil at their loved one’s bedside. Objectives: To develop and implement an educational intervention that improves learners’ knowledge and confidence in EOL patient and family care. To expand learner confidence to a dual level (learners become teachers) with a simplified and culturally sensitive electronic bedside teaching tool designed to guide learners and patients/families conversations. Methods: Curriculum was completed during MS3 ambulatory rotation and included pre-/posttests, an online case-based module, faculty demonstration, and learner role-play using the bedside teaching tool. Results: A total of 247 participants took the pretest, 222 participants took the posttest, and 222 participants matched the pre-/posttest surveys. Students’ knowledge of EOL care and the confidence to teach other learners and families about EOL care significantly improved after completing the curriculum. Conclusion: The DP-PC is a technology-savvy educational intervention that improves learner confidence and knowledge toward caring for dying patients and their families. Easy access, technology-based teaching tools may enhance bedside teaching of health-care learners and improve the care of patients and their families at the end of life.

How Come They Don’t Come? Identifying Reasons of No-Shows Among a Palliative Care Outpatient Clinic (S775)

Implications for Research, Policy or Practice. Hospice care providers can use pre-admission visits as an opportunity to promote accurate understanding of hospice care and to relieve seriously ill individuals’ and families’ anxiety in this often difficult decision-making process. Also, in-depth discussions with doctors regarding diagnosis/prognosis and end-of-life care options are needed for easier transition to hospice care.

The Double Parallel Curriculum in Palliative Care(DP-PC): Using a Double Parallel Education Strategy with Multimedia to Enhance Learners Knowledge and Skills in End of Life Palliative Care (EOL-PC) (TH325-C)

The Double Parallel Curriculum in Palliative Care(DP-PC): Using a Double Parallel Education Strategy with Multimedia to Enhance Learners Knowledge and Skills in End of Life Palliative Care (EOL-PC) (TH325-C) Jennifer Healy, DO, University of Texas Health Science Center, San Antonio, TX. Shuko Lee, MS, South Texas Veterans Health Care System, San Antonio, TX. Jeanette Ross, MD, University of Texas Health Science Center at San Antonio and South Texas Veterans Healthcare System, San Antonio, TX. Sandra Sanchez-Reilly, MD FAAHPM, University of Texas Health Science Center and South Texas Veterans Healthcare System, San Antonio, TX. Phylliss Chappell, MD, University of Texas Health Science Center at San Antonio, San Antonio, TX. Deborah Villarreal, MD, University of Texas Health Science Center at San Antonio, San Antonio, TX. (All authors listed above had no relevant financial relationships to disclose.)