TITLE:
Hospice Home Immersion Project: Advancing Medical Education
AUTHORS:
Marilyn R. Gugliucci, Himanshu Malhotra, Andrea Gaul
KEYWORDS:
Palliative and End of Life Care, Medical Education, Experiential Training
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.6 No.3,
March
19,
2015
ABSTRACT:
The University of New England College of Osteopathic Medicine (UNECOM) Hospice Immersion project was piloted in 2014 in southern Maine. It was designed and implemented as an experiential medical education learning model whereby medical students were “admitted” into the local Hospice Home to live there for 48 hours. Until this project, palliative and end of life care education at US Medical Schools and specifically UNECOM were accomplished through traditional medical education methods. The Hospice Immersion project utilizes qualitative ethnographic and autobiographic research designs, whereby a unique environment or “culture” (Hospice Home) is observed and life experiences of the medical student before, during, and immediately after the immersion are reported by him/her. The purpose of the Hospice Immersion project is to provide second year medical students with firsthand experiences of living in the Hospice Home for 48 hours to answer the question: “What it is like FOR ME to live in the Hospice Home?” The results focus on the students’ common themes that include 1) Unknown Territory; 2) Support; 3) Role of Staff; 4) Role of Immersion Learning in Palliative and End of Life Care; 5) Facing Death and Dying; and 6) Clinical Pearls. This project humanizes dying and death, solidified student realization that dying is a part of life and what an honor it is to be a part of the care process that alleviates pain, increases comfort, values communication, and human connections. Students report new found skills in patient care such as the 1) importance of physical touch; 2) significance of communication at the end of life for the patient, family, and staff; 3) the value of authenticity and sincerity that comes from being comfortable with oneself, which allows silence to communicate caring; 4) connection with and awareness of the person (rather than their terminal illness) and their family; and 5) the importance of speaking with patients and their families about end of life plans in advance. Although this is a time intensive experience for the faculty member and the Hospice Home staff, the depth of learning experienced by the students and opportunities to advance medical education in death and dying are well worth the efforts.