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Syllabus
MD236170E Palliative care
Single-Cycle Degree Program
The University of Georgia 2024 წ.
Given Credits: 2 ECTS
Curator : Abesadze Ioseb
E-mail: i.abesadze@ug.edu.ge
Admission criteria to the course
  • MD236160E Oncology - Corequisite
  • MD235110E Internal Medicine II - Prerequisite
  • MD235210E Surgery II - Prerequisite
  • MD235220E Anesthesiology and Reanimatology - Prerequisite
Description

Students will familiarize with specifics of palliative care by observation and participation in clinical practice, including consultations, physical examination, leading patient records, observation of palliative patient in outpatient and inpatient settings, educating patient relatives regarding the patient condition, palliative home care, monitoring palliative patient in hospice, various procedures and manipulations, communicating with patients, their relatives, colleagues, medical and nonmedical personnel, caring for inpatient palliative patients.
Goals

The aim of the course is to give students knowledge regrading basic principles and methods of palliative care, as well as basic skills necessary for working and communicating with patients and their relatives. Course aims to equip students with necessary theoretical knowledge and practical skills for communication with patient in palliative care (inpatient or outpatient settings).
Result
Skills

  • საკუთარი კომპეტენციის ფარგლებში ახორციელებს პაციენტის პირველად პალიატიურ მზრუნველობას;  

  • ახორციელებს შესაბამის მოვლას და მზრუნველობას ტერმინალურ სტადიაში მყოფი პაციენტებისათვის; 

  • აფასებს პალიატიური პაციენტის საერთო მდგომარეობას, აფასებს ტკივილს და სხვა სიმპტომებს, ახდენს კვლევის შედეგების ინტერპრეტაციას და განსაზღვრავს ფარმაკოლოგიურ და არაფარმაკოლოგიური მართვის დაშუალებებს; 

  • ახდენს ნაწოლების და სტომის მოვლას; Length

Lecture :    Day: 1
Hours: 1
Practical work :    Day: 1
Hours: 4
Student Workload
Sum:50 Hours
Contact hours
Attendance on Lectures 5
Practical training 20
Exams 2
Presentation 2
Independent hours
Independent studies 21
Teaching and Learning Methods
  • Interactive Lectures
  • Theoretical and practical learning – Seminars
  • Learning with the usage of a simulator
  • Teaching by using the simulators
  • Scenarios-based simulation training
  • Bedside teaching
  • Teaching through standardized patients
  • Playing patient/doctor roles
Bibliography
Main bibliography
Oxford textbook of palliative medicine: 5th ed.Cherny, Nathan and other2015
Education In palliative and end-of-life care for oncology2013
Additional bibliography
Textbook of palliative medicine and supportive care : 2nd ed.Bruera, Eduardo and other2015
Principles and practice of palliative care and supportive oncology-4th edAnn M. Berger2013
Tools for the Patient Presentation
APA Style Introduction
1 Day

Lecture

Theme

Lecture: Introduction to the course of palliative care, lectures, quiz and assessment; Introduction to Palliative Care and Palliative Medicine.

Seminar/Practical Work: General review of lectures and seminars, quiz and assessment criteria; The aim of Palliative Care, its general principles, types, methods and ways of implementation (Philosophy of Hospice; What is Palliative Care, Definition of the terminology); Patients and selection criteria, patients’ rights; The importance of protection of ethical and legal aspects; History of Palliative Care; Importance of multidisciplinary team and working principles; Assessment of palliative patients; Effective communication with the patients, family, carers, sharing “bed news”; Palliative Care for patient – determination of treatment strategy;

www.palliativecare.org.ge

http://www.who.int/cancer/palliative/definition/en/.



Reading Materials:
  • Oxford textbook of palliative medicine: 5th ed. Cherny, Nathan and other page: 376-390 ; 506-559 ; 577-588 ; 606-631 ; 817-875 ; chapter - NULL
2 Day

Lecture (Quiz)

Theme

Lecture: Chronic pain assessment and management

Seminar/Practical Work: Definition of pain, types, development mechanisms, total pain; Assessment of pain, pain assessment scales and management; WHO three step ladder for pain management and pharmacokinetics and pharmacodynamics of those medication used on each step; Main analgesic groups; Opioid groups, doses, their prescription and titration in palliative care patients, regular and additional doses; Ways of administration; Formulas for opioid conversion; Side effects of opioids and their management; Adjuvants; Co­analgesics, their pharmacokinetics, pharmacodynamics, side­effects, their indications and contraindications for prescription; Non Pharmacological methods of pain management.

www.palliativecare.org.ge



Reading Materials:
  • Oxford textbook of palliative medicine: 5th ed. Cherny, Nathan and other page: 506-559 ; 577-588 ; 606-631 ; 817-875 ; chapter - NULL
  • Education In palliative and end-of-life care for oncology ; chapter - 1-2

Type of Assessment:     Written exam - 5;     Practice - 5;

3 Day

Lecture (Quiz)

Theme

Lecture: Symptom assessment and their management in palliative care (pharmacological and non­pharmacological management)

Seminar/Practical Work: Breathlessness, dyspnea; Nausea, Vomiting – etiology, diagnosis and management; Weakness, fatigue– etiology, diagnosis and management; Anorexia, cachexia– etiology, diagnosis and management; Anxiety– etiology, diagnosis and management; Diarrhea, constipation– etiology, diagnosis and management; Ascites/Plevritis/pericarditis, edema– etiology, diagnosis and management; Intestinal obstruction– etiology, diagnosis and management; Icterus– etiology, diagnosis and management; Delirium – etiology, diagnosis and management; Depression– etiology, diagnosis and management; Insomnia– etiology, diagnosis and management; Menopause and connected symptoms– etiology, diagnosis and management; Mucositis– etiology, diagnosis and management; Artificial nutrition, hydration;



Reading Materials:
  • Oxford textbook of palliative medicine: 5th ed. Cherny, Nathan and other page: 409-437 ; 457-466 ; 661-685 ; 702-712 ; 1074-1100 ; 919-929 ; chapter - NULL

Type of Assessment:     Oral exam - 5;     Practice - 5;

4 Day

Lecture (Quiz)

Theme

Lecture: The last hours and its management – terminal phase – patient management and aspects of family care; Main symptoms at the terminal phase.

Seminar/Practical Work: Palliative care in the last days and hours of life; Symptoms in the last hours of life and their management; Caring for the family Aspects of caring for the family of the patients at the terminal phase of their disease.



Reading Materials:
  • Oxford textbook of palliative medicine: 5th ed. Cherny, Nathan and other page: 1123-1133 ; 1101-1109 ; chapter - NULL
  • Education In palliative and end-of-life care for oncology page: 55-80

Type of Assessment:     Written exam - 5;     Practice - 5;

5 Day

Lecture (Quiz)

Theme

ecture: Death, grief and family support; conflicting situations, suicide; Proceeding medical documentation in palliative care.

Seminar/Practical Work: Conflicting situations and their management in palliative care; Suicide and its prevention; Grief; Psychological help; Support of the health care providers working in the palliative care; Proceeding medical documentation and informing the state agencies and management of patient information and receive notifications in / out / in case of death, illness history of production; Operation of inpatient and outpatient care for palliative care patients.

www.palliativecare.org.ge



Reading Materials:
  • Oxford textbook of palliative medicine: 5th ed. Cherny, Nathan and other page: 246-259 ; 1048-1074 ; 1110-1112 ; chapter - NULL

Type of Assessment:     Written exam - 5;     Practice - 5;

6 Day

Presentation

Presentation
• The presenter did not seem to know how to prepare or use visual aids effectively. Presenter didn’t know the topic at all and could not communicate the topic at all 0%
• Often unclear and disorganized, rambled too much. The presentation was confusing and difficult to follow. Transitions between sections poor. Poor quality visual aids, but technically accurate, poor eye contact 25%
• Not always clear or concise. Organization was adequate, but weak. Occasionally wandered and was sometimes difficult to follow. Transitions between sections weak. Marginally acceptable, too complex, crowded, difficult to read or interpret. Adequate coordination with content. Used only adequately. Showed little understanding of how to prepare and use visual aids, Adequate stage presence. Read parts, fumbled with notes, several distracting mannerisms, minimal gestures, minimal eye contact 50%
• Usually clear, concise, well organized. Most of the presentation was easy to follow. Usually clear, easy to interpret, easy to read. Transitions between sections usually coordinate. Generally well coordinated with content, design was normal. Demonstrated some understanding of how to use visual aids. Good stage presence. Fairly confident, used notes fairly well, good gestures, acceptable audience attention and eye contact 75%
• Consistently clear, concise, well organized. Points were easy to follow because of the organization. Very creative and original. Transitions between sections smooth and coordinated. Imaginative design and use of materials, excellent stage presence. Confident, used notes well, at ease, excellent gestures, good audience attention, good eye contact 100%
Research Term Paper
• Student does not possess the information at all 0%
• Information presented is incomplete, reasoning is inconsequent, and conclusions are not evident 25%
• Student possesses required information partially; reasoning is more or less logical; conclusions require more arguments 50%
• Student possesses most part of the required information, reasoning is logical and consequent, and conclusions are evident 75%
• Student possesses all the essential information, reasoning is logical and consequent; conclusions are evident and arguments clearly presented 100%



16,17,18 Day

Final Exam

Exam topic

Exam Type - Written exam, Practice

Criteria Point sum
Open Questions 5
• Answer is exact and precise, terminology is used appropriately 100%
• Answer is correct, but not exhaustive, terminology is described precisely 75%
• Answer is not exhaustive, terminology precision is violated 50%
• Answer is fragmented 25%
• Answer is incorrect 0%
Tests 10
• Answer is correct 100%
• Answer is incorrect 0%
Case review and solve 5
• Case is solved correctly and in details 100%
• Case is partially solved, no essential mistakes 75%
• Case is partially solved, minor mistakes and errors observed 50%
• Case is partially solved, essential mistakes done 25%
• Case is not solved/is solved incorrectly 0%
Practical Exercises 20
• 0%



აკადემიური ეთიკის დაცვა არის კურსის გავლის აუცილებელი ელემენტი
Evaluation system:
Lecture (Quiz) 40 point 40%
Presentation
  • Referat - 12 point (Min 3 point)
  • Presentation - 8 point (Min 2 point)
    • Presentation - 40%, theme for presentation - 60%
    Note: It is mandatory to overcome the minimum in each component. Otherwise, the overall assessment presentation points will be abolished.
20 point 20%
Final Exam
  • Written exam - 20 point (Min 10 point)
  • Practice - 20 point (Min 10 point)
    • Presentation - 40%, theme for presentation - 60%
    Note: It is mandatory to overcome the minimum in each component. Otherwise, the overall assessment presentation points will be abolished.
40 point 40%

Point GPA The university assessment   The general assessment in Georgia
97-100 4,00 A+ A Excellent
94-96 3,75 A
91-93 3,50 A-
87-90 3,25 B+   Very good
84-86 3,00 B B
81-83 2,75 B-  
77-80 2,50 C+   C good
74-76 2,25 C
71-73 2,00 C-
67-70 1,75 D+   D Satisfactory
64-66 1,50 D
61-63 1,25 D-
51-60 1,00 E E Sufficient
Not passed
41-50   FX FX Insufficient
<40   F F Failed





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