PHILADELPHIA—While future physicians in the United States are extensively trained in how to treat patients and help prevent disease, not all medical students learn the intricacies of palliative care—specialized medical care focused on relieving the symptoms and stress of a serious illness. But now, a new four-year curriculum launched by the Perelman School of Medicine (PSOM) at the University of Pennsylvania aims to change this through an innovative approach to teaching students how to effectively communicate with, support, and care for patients with serious illness.
While other medical schools across the country often include palliative care as an element of training, it is rare for a school to have a dedicated, robust curriculum across all four years. The new curriculum, called “CARE-7,” is built on the essential palliative care competencies and spans all four years of medical school. The educational program utilizes simulation-based experiential learning, along with structured, immersive clinical practice, to help students gain communication and palliative care skills. “CARE” stands for communication, attention, responsiveness, and empathy while the “7” references the seven overarching goals of the curriculum, such as effective communication that incorporates the patient’s values, cultural context, and end of life goals.
“Good palliative care practices make for better physicians and better patient care,” said Suzanne Rose, MD, MSEd, senior vice dean for Medical Education at PSOM. “The communication skills learned through palliative care education are universal for physicians, as they are focused on helping to improve the quality of life and care for the patient and their family members. Regardless of the specialties our students go into, it is of the utmost importance for future doctors to have these foundational skills.”
Palliative care is a resource for anyone living with a serious, chronic, or life-threatening illness, aimed at improving a patient’s quality of life. Such care can be given alongside other disease modifying or curative treatments and incorporates pain and symptom management, psychosocial and spiritual support, and communication around medical decisions. With at least 12 million adults and 400,000 children living with a serious illness, such as cancer, heart disease, or dementia, the need for palliative care has never been greater—especially as this number is expected to increase due to the aging population.
“Every physician throughout their career will be in contact with patients with severe illness,” said Nadia Bennett, MD, MSEd, an associate dean of Clinical and Health Systems Sciences Curriculum at PSOM and CARE-7 advisor. “This curriculum teaches students at every stage of their education how to communicate, improve care, ease suffering, and give dignity to patients and their families.”
The four-year curriculum follows a step-wise approach: first, pre-clerkship students are introduced to core concepts and skills and exposed to clinical palliative care. Then, clerkship students build on those lessons by learning more advanced skills and concepts that they are prompted to apply clinically. Finally, post-clerkship students practice advanced skills tailored to their area of interest and have opportunities to pursue additional training through electives. In each step, students learn through both direct patient care and simulation. Furthermore, coaches are available along with other facilitators for additional mentoring and instruction when needed.
“This education will pay dividends in multiple ways,” said Alana Sagin, MD, an associate professor of Hospice and Palliative Care and CARE-7 curriculum director. “We hope that CARE-7 will encourage students to analyze their own practice as they encounter more opportunities in residency and beyond. The same mindset will undoubtedly help them in other areas of their practice and help them grow into better physicians.”
In addition to this curriculum, new efforts across PSOM aim to bolster palliative care education. For example, PSOM medical students started a palliative care special interest group. And starting in 2023, the Berkman Summer Internship in Palliative Care will provide an opportunity for students with backgrounds underrepresented or historically excluded from medicine to gain mentorship, clinical exposure, and education through an eight-week summer intensive.
The CARE-7 curriculum is generously funded by Barbara M. Jordan, a Penn Medicine Board member and spouse of the late Henry A. Jordan, M'62 and Res'67. Jordan, who works with palliative care and hospice patients and families, has been a passionate and long-term advocate for the importance of a program like CARE-7 in medical students’ curriculum.
Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System, which together form a $9.9 billion enterprise.
The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $546 million awarded in the 2021 fiscal year.
The University of Pennsylvania Health System’s patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center—which are recognized as one of the nation’s top “Honor Roll” hospitals by U.S. News & World Report—Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nation’s first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.
Penn Medicine is powered by a talented and dedicated workforce of more than 47,000 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2021, Penn Medicine provided more than $619 million to benefit our community.