Most people wish to die at home yet significant barriers exist in accessing care in one’s home, especially for individuals with caregiver and/or housing instability. Across the U.S., residential homes for the dying are opening to address gaps in end-of-life care by recruiting community members to serve as caregivers to hospice patients during their final days. This paper describes a blended-experiential training program, informed by both an evidence-based educational framework and transformative learning theory, that trains undergraduate students to serve as surrogate family members to hospice patients in residential care homes. This study analyzed data from a sample of undergraduate students (n = 35) who participated in an 8-week program. Applying Kirkpatrick’s evaluation model, study results indicate the program provided essential knowledge and skills in end-of-life care, benefiting both student learning outcomes and resident care.
Anderson, W. G., Williams, J. E., Bost, J. E., & Barnard, D. (2008). Exposure to death is associated with positive attitudes and higher knowledge about end-of-life care in graduating medical students. Journal of Palliative Medicine, 11(9), 1227-1233.
2.
ChanW. C. H.TinA. F.FongA.WongK. L. Y.TseD. M. W.LauK. S.ChanL. N. (2016). Impact of death work on self: Existential and emotional challenges and coping of palliative care professionals. Health & Social Work, 41(1), 33–41.
3.
Crawford, G. B., & Zambrano, S. C. (2015). Junior doctors' views of how their undergraduate clinical electives in palliative care influenced their current practice of medicine. Academic Medicine, 90(3), 338--344.
4.
CrossS. H.WarraichH. J. (2019). Changes in the place of death in the United States. New England Journal of Medicine, 381(24), 2369–2370.
5.
GomesB.CalanzaniN.GyselsM.HallS.HigginsonI. J. (2013). Heterogeneity and changes in preferences for dying at home: Systematic review. BMC Palliative Care, 12(1), 1-13. https://doi.org/10.1186/1472-684X-12-7
6.
GrantH.ScottK. (2015). An introduction and overview of social model hospice care. Journal of Hospice and Palliative Nursing, 17(5), 456–461.
7.
GrbichC. (2012). Qualitative data analysis: An introduction. SAGE.
8.
HarrisD. G.ColesB.WilloughbyH. M. (2015). Should we involve terminally ill patients in teaching medical students? A systematic review of patients views. BMJ Supportive & Palliative Care, 5(5), 522–530.
9.
HetzlerP. T.DugdaleL. S. (2018). How do medicalization and rescue fantasy prevent healthy dying?AMA Journal of Ethics, 20(8), E766–E773. https://doi.org/10.1001/amajethics.2018.766
10.
Institute of Medicine. (2015). Dying in America: Improving quality and honoring individual preferences near the end of life. The National Academies Press. https://doi.org/10.17226/18748
11.
KhandelwalN.CurtisJ. R.FreedmanV. A.KasperJ. D.GozaloP.EngelbergR. A.TenoJ. M. (2017). How often is end-of-life care in the United States inconsistent with patients’ goals of care?Journal of Palliative Medicine, 20(12), 1400–1404. https://doi.org/10.1089/jpm.2017.0065
12.
KirkpatrickD. L. (1996). Evaluating training programs: The four levels (1st ed.). Berrett-Koehler.
13.
MezirowJ. (2000). Learning to think like an adult. In J. Mezirow & Associates (Eds.), Learning as transformation: Critical perspectives on a theory in progress (pp. 3–33). Jossey-Bass.
14.
MottM. L.Gorawara-BhatR.MarschkeM.LevineS. (2014). Medical students as hospice volunteers: Reflections on an early experiential training program in end-of-life care education. Journal of Palliative Medicine, 17(6), 696–700. https://doi.org/10.1089/jpm.2013.0533
15.
PatelS.Pelletier-BuiA.SmithS.RobertsM. B.KilgannonH.TrzeciakS.RobertsB. W. (2019). Curricula for empathy and compassion training in medical education: A systematic review. PLoS One, 14(8), e0221412. https://doi.org/10.1371/journal.pone.0221412
16.
RandallD.GarbuttD.BarnardM. (2018). Using simulation as a learning experience in clinical teams to learn about palliative and end-of-life care: A literature review. Death Studies, 42(3), 172–183. https://doi.org/10.1080/07481187.2017.1334006
17.
RatanawongsaN.TeheraniA.HauerK. (2005). Third-year medical students’ experiences with dying patients during the internal medicine clerkship: A qualitative study of the informal curriculum. Academic Medicine: Journal of the Association of American Medical Colleges, 80(7), 641–647.
18.
SaldañaJ. (2015). The coding manual for qualitative researchers. SAGE.
19.
SawyerT.WhiteM.ZaveriP.ChangT.AdesA.FrenchH.AndersonJ.AuerbachM.JohnstonL.KesslerD. (2015). Learn, see, practice, prove, do, maintain: An evidence-based pedagogical framework for procedural skill training in medicine. Academic Medicine, 90(8), 1025–1033.
20.
SmithJ.OnaF. V. (1995). Mt Carmel house: A home for terminally ill patients who cannot go home. Cancer Investigation, 13(2), 239–243.
21.
TeixeiraM.AlvarelhãoJ.Neri de SouzaD.TeixeiraH.AbreuW.CostaN.MachadoF. (2019). Healthcare professionals and volunteers education in palliative care to promote the best practice—An integrative review. Scandinavian Journal of Caring Sciences, 33(2), 311–328.
22.
WalkerK. L. (1997). Do you ever listen? Discovering the theoretical underpinnings of empathic listening. International Journal of Listening, 11(1), 127–137. https://doi.org/10.1207/s1932586xijl1101_7
23.
Weisse, C.S., Martin, K., & Aitken, G. (2015). Engaging students in end of life care: Cultivating a community of compassionate caregivers. Presented at the meeting of the Northeast Association of Advisors to the Health Professions, Albany, NY.
24.
Weisse, C.S., Sapienza, B., & Foster, S. (2018). Opportunities for direct patient care in residential homes for the dying: Learning how to provide care when there is no cure. The Advisor, 38(2), 9-19. https://sites.psu.edu/sciadvising/files/2018/06/Hospice-13ns8aq.pdf
25.
Weisse, C. S., Melekis, K., & Hutchins, B.(2019). Providing end-of-life care: Increased empathy and self-efficacy among student caregivers in residential homes for the dying. American Journal of Hospice and Palliative Medicine, 36(6), 538-545. doi:10.1177/1049909118820844.
