Professional Preparation for End-of-Life Care

Scientific and clinical knowledge and skills, including:

· Learning the biological mechanisms of dying from major illnesses and injuries

· Understanding the pathophysiology of pain and other physical and emotional symptoms

· Developing appropriate expertise and skill in the pharmacology of symptom management

· Acquiring appropriate knowledge and skill in nonpharmacological symptom management

· Learning the proper application and limits of life- prolonging interventions

· Understanding tools for assessing patient symptoms, status, quality of life, and prognosis

Interpersonal skills and attitudes, including:

· Listening to patients, families, and other members of the health care team

· Conveying difficult news

· Understanding and managing patient/family response to illness

· Providing information/guidance on prognosis/options

· Sharing decision making/resolving conflicts

· Recognizing and understanding one's own feelings about dying and death

· Cultivating empathy

· Developing sensitivity to religious, ethnic, and other differences

Ethical and professional principles, including:

· Doing good and avoiding harm

· Determining/respecting patient/family preferences

· Being alert to personal and organizational conflicts of interests

· Understanding societal and population interests and resources

· Weighing competing objectives or principles

· Acting as a role model of clinical proficiency, integrity, and compassion

Organizational skills, including:

· Developing and sustaining effective professional teamwork

· Understanding relevant rules/procedures set by health plans, hospitals, and others

· Learning how to protect patients from harmful rules and procedures

· Assessing and managing care options, settings, and transitions

· Mobilizing supportive resources, such as palliative care consultants and community-based assistance

· Making effective use of existing financial resources and cultivating new funding sources