H American Board of Internal Medicine Clinical Competence in End-of-Life Care*

Components

Core Competencies

Medical Knowledge

Palliative care

• Assessment and treatment of psychological distress

• Pharmacological and nonpharmacological treatment of pain and other symptoms

Interviewing/Counseling skills

Listening

Truth telling

Giving bad news

Discussing dying as a process

Dealing with families of dying patients

Team Approach

Understanding multidisciplinary natures of end-of-life care (physician, nursing staff, social services, palliative care or hospice team, pharmacist, chaplain, patient, patient's family, patient advocate)

*  

American Board of Internal Medicine, Caring for the Dying: Identification and Promotion of Physician Competency. Philadelphia, Author, 1996, p. 41. Used with permission.



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OCR for page 405
--> H American Board of Internal Medicine Clinical Competence in End-of-Life Care* Components Core Competencies Medical Knowledge Palliative care • Assessment and treatment of psychological distress • Pharmacological and nonpharmacological treatment of pain and other symptoms Interviewing/Counseling skills Listening Truth telling Giving bad news Discussing dying as a process Dealing with families of dying patients Team Approach Understanding multidisciplinary natures of end-of-life care (physician, nursing staff, social services, palliative care or hospice team, pharmacist, chaplain, patient, patient's family, patient advocate) *   American Board of Internal Medicine, Caring for the Dying: Identification and Promotion of Physician Competency. Philadelphia, Author, 1996, p. 41. Used with permission.

OCR for page 405
--> Symptom Assessment and Management Communication skills Comfort Use of opioids, sedatives, or adjuvant analgesics, NSAIDs Control of dyspnea AHCPR and WHO guidelines Professionalism Altruism Accountability Confidentiality Transference and counter transference Nonabandonment Honoring patients' wishes Respect for colleagues Humanistic Qualities Integrity Compassion Sensitivity to patient needs for comfort and dignity Respect Courtesy Medical Ethics Advance directives, DNR/DNI orders, Conflicts of interest Futility Physician-assisted suicide Nutrition/hydration Surrogate decisionmaking Double effect