OHSU

Palliative Care Assessment Video

The Palliative Care Assessment teaching video demonstrates an interview between OHSU's Dr. Molly Osborne, medical student Kyle Miller and "Jeanne Miller," her patient of many years, powerfully portrayed by actress Megan Cole. This is a very delicate meeting, requiring great skill and empathy on the part of the doctor, because "Jeanne" has recently been told that she has inoperable pancreatic cancer.

During this follow-up appointment, Dr. Osborne, Associate Dean for Student Aff airs, adroitly demonstrates for Kyle (and the viewer) the key elements of a psychosocial interview, modeling through both words and body language how to be an engaged, empathetic listener. How to ask the right questions so that she and "Jeanne" can work together to meet her growing needs. How to help "Jeanne" balance hope and fear, and how to set goals for the next visit. How to allow room for "Jeanne" to be present to her own emotions, so essential to the healing she needs within the context of her incurable disease. And, perhaps most important of all, how to reassure "Jeanne" that her trusted doctor will be there for her throughout her illness. Thanks to Megan Cole's gifted acting and the gentle skill with which Dr. Osborne leads "Jeanne" through the interview, the video is deeply moving. Its emotional power takes teaching far beyond the traditional classroom approach, providing layers of rich learning.

It will be seen prior to students' Internal Medicine rotation - a time when they are most likely to work with a dying patient. During their vital 3rd Year, students will also participate in an on-line module, learning the skills needed to help a patient fill out a POLST (Physicians Orders for Life-Sustaining Treatment) form, and how to ensure the patient's wishes are carried out when care is needed. This module will be part of their Rural rotation in the community, where they will have opportunities to practice their newfound skills.

The 3rd Year will also offer hands-on teaching, including the care of dying children (Pediatrics) and the communication skills required to support a patient whose baby was stillborn (OB/GYN). By the end of the year, students will have been exposed to Palliative Care and its more human, patient-centered teaching on every rotation. Many of the state's leading Palliative Care experts have partnered to create this new curriculum. Under Osborne's leadership, they have broken new ground in medical education - integrating Palliative Care with existing curriculum in ways that are both OHSU CENTER for ETHICS in HEALTH CARE virtual and hands-on, and available both on and off campus - to deepen and expand students' learning.

The inspiration for this new thinking is the work of beloved physician, teacher and Ethics Center founder, Miles Edwards, MD, who died in 2006. Like Edwards a pulmonary and critical care physician, Osborne has assembled an extraordinary team of experts that is dedicated to teaching the human side of medicine that Edwards mentored so well at OHSU.

The Miles J. Edwards Chair, created to honor Edwards' powerful legacy, is focused on statewide education, as well as the teaching of students, so the 'Interview' video will also become part of Ethics Center conferences, reaching health care professionals of all disciplines throughout the state.

Some of these professionals, in turn, will go on to become mentors for others. (Some will no doubt serve as the rural health practitioners mentoring OHSU students.) And in this way lifelong learners will be created, and mentors will teach generations of future mentors, each benefiting from the pooled wisdom of outstanding leaders in the field. The benefits this learning will bring to future patients are immeasurable. "Miles was such an inspiring teacher," remembers Dr. Robert 'Hugo' Richardson, OHSU Professor and Ethics Center Palliative Care Scholar, who generously underwrote the creation of the video in tribute to his close friend and colleague. "He was unusually flexible in his teaching, and I believe he would embrace wholeheartedly these powerful new teaching methods that will impact not only future generations of OHSU medical students, but also of health care professionals in every corner of our state."