The EPEC curriculum covers key competencies for all physicians who care for patients at the end of life. The course covers fundamental skills in palliative care, ethical decision making, symptom management, communication, and psychosocial aspects of care at the end of life.
Organized as a two-and-a-half-day conference, the curriculum includes educational sessions, videotape presentations, group discussions, and practical exercises to provide both didactic and interactive learning opportunities. The conference is divided into four 30-minute plenary sessions and twelve 45-minute workshops. Each of the plenary sessions begins with a motivational videotape that introduces particular issues in end-of-life care and highlights the special role of physicians in caring for dying patients. Didactic, lecture-style presentations follow.
In the workshops, videos are used to set up group discussions. These "trigger tapes" feature physician-actors (doctors who are also professional actors) portraying realistic end-of-life situations. The group then discusses the questions and issues raised by the tape. Moderators can refer to the training manual for helpful discussion questions and overviews of key concepts.
Conference participants will not only participate as trainees themselves, but will be taught how to train others using the EPEC curriculum. Physician-educators will receive complete copies of the curriculum, including workbooks, videotapes and slides, and the trainer's manual, so that they may tailor training in end-of-life care for other physicians in their respective institutions, systems, regions, and specialties.
Designers hope the program will help create "local experts" in end-of-life care across the country. The project’s immediate goal is to train 250 physician-educators in the EPEC curriculum. These physician-educators will be equipped to offer training to practicing physicians as well as to provide advice and consultation to physicians who provide care for patients at the end of life. According to Dr. Emanuel, the curriculum and training are designed to give the project "a life of its own" as trainees train new trainers, adapt the curriculum to specific audience needs, and expand the core curriculum's reach into medical school curricula and residency training.
Two advisory groups, which included the most prominent clinical and ethics experts in the United States, developed the curriculum, which represents a synthesis of the best available information and learning tools. The advisory groups compiled a list of recommended materials for physician education on end-of-life issues. Additional materials were developed specifically for the EPEC project.
A pilot meeting to introduce the final curriculum will be held in September. On October 16-18, about 65 physician-educators will meet in Chicago for the first conference and “train-the-trainer” session. Additional regional conferences will take place in Boston, November 13-15; in Phoenix, January 15-17; and in Atlanta, February 19-21. Applications are currently being solicited through the Journal of the American Medical Association or from the website at www.ama-assn.org/EPEC. Dr. Emanuel reports that more than 100 applications have already been received from physicians who wish to participate and that she and the EPEC project staff are "very pleased" with the process so far.
To reach physicians who may not be able to attend a conference or training session, a self-directed educational module will also be produced. The EPEC Monograph, a learning program that physicians who can complete at their own pace, will be made available to physicians some time in the summer of 1999 and will incorporate the lessons learned during the conferences. Physicians will be able to apply for continuing medical education (CME) credit for completing the course of study.
For more information contact The EPEC Project, American Medical Association, 515 North State Street, Chicago, Illinois 60610, 312.464.4979.
Sue Trinidad, whose background includes bioethics and public education, lives in Oregon.
<<< Previous Next >>> [ Go Up ]