Undergraduate

The UBC Medical Curriculum has components of Palliative Care education incorporated throughout the 4 years. The “spiral” curriculum is supposed to have repeated exposure to core themes, with increasing sophistication of learning with increasing general medical knowledge and understanding of context.

There are core components that every student has to do, and elective components that students can choose if they wish to explore palliative care in more detail. The Division offers a flexible learning option called the Legacy Project, where students are paired with patients to assist them with creation of a legacy item for their successors.

Clinical electives are not able to be offered to all students due to lack of training capacity. Interested students need to apply for an elective early and be willing to travel in order to have a chance of being able to take one.

Teaching Objectives

Attitudes

  • To show students that the therapeutic process involves more than diagnosing and attempting to revert an altered pathophysiologic process and that illness is a complex state with physical, emotional, psychosocial and spiritual elements.
  • To demonstrate the interdisciplinary approach of Palliative Care.
  • To demonstrate preventive steps to avoid physical, psychosocial, and emotional problems.
  • To emphasize that all interventions should be centered on the patient’s needs, desires and beliefs, thus ensuring patient control, whenever possible, of decisions which affect them.
  • To have students identify their own attitudes toward death, and to identify and respect family attitudes towards death.
  • To enable students to understand the unit of care, the family, through consideration of the family background and the impact of illness on the family group.
  • To demonstrate how the impact and interpretation of illness depends on personal attitudes by providing examples of harmonizing the Canadian medical model of care with the cultural and spiritual backgrounds of patients and families.
  • To involve students in discussions on ethical aspects of caregiving including euthanasia, resuscitation, truth telling, paternalism, aggressive versus palliative interventional therapy, incompetent patients, fairness in the health care system and strategies for resolving ethical issues.

Skill

  • To enable students to integrate knowledge from across disciplines and to critically appraise clinical data, diagnostic tests and the literature in order to assist with decisions to initiate or stop various investigations and therapy.
  • To demonstrate various techniques for communication with patients and families as well as how and why these techniques should be modified based on the personal, educational and cultural background of the patient and family.

Knowledge

  • To describe the pathophysiology of common distressing symptoms in patients with advanced chronic disease and to suggest appropriate pharmacologic and non-pharmacologic techniques to combat these symptoms.
  • To have students identify various organizational arrangements for delivery of Palliative Care and the relationship of these organizational structures to the existing health care system including the community resources available to patients with advanced disease and their families.
  • To describe the elements of grief reactions and some techniques to prevent the development of pathologic reactions through caring for the patient and bereaved family.

Legacy Project

Since 2016, UBC has been offering an opportunity for medical students to participate in “The Legacy Project”: working with patients wanting to leave a tangible legacy item for their loved ones for after they die. Over forty students have participated, most as part of an undergraduate FLEX course, but some as a volunteer activity. The following is an extract from a message to the project creator from a recent student participant:

“Here is my update on working with Mr. J. I finished the legacy project with Mr. J this week. It was a wonderful experience for both him and myself. I visited his home twice over the last month. The legacy document consist of his answers to interview questions that we came up with together. The document ends with a poem that he had written. Mr. J gave me a long list of people that he wants me to email the legacy document to on the week of April 15th. These people include his family members and many of the healthcare workers who took care of him. Mr. J also wanted me to share the legacy document with you. He was really happy with the process and the final product, so he encouraged me to share his experience with more people, and to normalize discussions on illness, life, and death.”

Mr. J’s legacy document can be seen here: Mr. Jiwa’s Legacy Project

Information about the Legacy Project can be seen here: Legacy Project Information

Students or residents interested in working with a patient to create a legacy project are encouraged to contact Dr. Pippa Hawley (phawley@bcccancer.bc.ca).