BOX S.2
Scientific and clinical knowledge and skills, including: • Learning the biological mechanisms of dying from major illnesses and injuries • Understanding the pathophysiology of pain and other physical and emotional symptoms • Developing appropriate expertise and skill in the pharmacology of symptom management • Acquiring appropriate knowledge and skill in nonpharmacological symptom management • Learning the proper application and limits of life-prolonging interventions • Understanding tools for assessing patient symptoms, status, quality of life, and prognosis
Interpersonal skills and attitudes, including: • Listening to patients, families, and other members of the health care team • Conveying difficult news • Understanding and managing patient and family responses to illness • Providing information and guidance on prognosis and options • Sharing decisionmaking and resolving conflicts • Recognizing and understanding one's own feelings and anxieties about dying and death • Cultivating empathy • Developing sensitivity to religious, ethnic, and other differences
Ethical and professional principles, including: • Doing good and avoiding harm • Determining and respecting patient and family preferences • Being alert to personal and organizational conflicts of interests • Understanding societal/population interests and resources • Weighing competing objectives or principles • Acting as a role model of clinical proficiency, integrity, and compassion
Organizational skills, including: • Developing and sustaining effective professional teamwork • Understanding relevant rules and procedures set by health plans, hospitals, and others • Learning how to protect patients from harmful rules and procedures • Assessing and managing care options, settings, and transitions • Mobilizing supportive resources (e.g., palliative care consultants, community-based assistance) • Making effective use of existing financial resources and cultivating new funding sources |