Reflective practice and palliative care education: A clerkship responds to the informal and hidden curricula Journal Article


Authors: Fins, J. J.; Gentilesco, B. J.; Carver, A.; Lister, P.; Acres, C. A.; Payne, R.; Storey-Johnson, C.
Article Title: Reflective practice and palliative care education: A clerkship responds to the informal and hidden curricula
Abstract: The authors discuss the damaging influence of informal and hidden curricula on medical students and describe a two-week clerkship in pallative care and clinical ethics at their school (Weill Medical College of Cornell University). This required clerkship, begun in 1999, uses reflective practice and a special pedagogic technique, participant observation, to counteract the influences of the informal and hidden curricula. This technique seeks to immerse the participant observer in the context of care. In their role as participant observers, students are relieved of any direct clinical responsibilities for two weeks so they have time for the careful observation and reflection required and also can consider the humanistic dimensions of practice, which are often displaced by the need to master diagnostic and therapeutic skills. Course objectives include identifying psychosocial and contextual factors that influence care, principles of pain and symptom management, and ethical and legal issues at the end of life. Students are expected to learn how to apply ethical norms to patient care, describe methods of pain and symptom management, communicate in an effective and humanistic manner, and articulate models of patient-centered advocacy. The clerkship fosters professionalism in patient care, appreciation of cultural diversity, and the student's ability to assume responsibility for developing competency in these areas. Although it is too early to know whether this clerkship will ultimately affect the practice patterns of students who experience it, short-term evaluation has been very favorable.
Keywords: clinical practice; palliative care; diagnostic procedure; palliative therapy; teaching; patient care; professional practice; clinical education; curriculum; clinical competence; interpersonal communication; human relation; medical ethics; social psychology; medical school; competence; human rights; death and euthanasia; education, medical, undergraduate; humans; human; priority journal; article; pedagogics; clinical clerkship; ethics, clinical
Journal Title: Academic Medicine
Volume: 78
Issue: 3
ISSN: 1040-2446
Publisher: Lippincott Williams & Wilkins  
Date Published: 2003-03-01
Start Page: 307
End Page: 312
Language: English
PUBMED: 12634214
PROVIDER: scopus
DOI: 10.1097/00001888-200303000-00015
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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  1. Richard Payne
    68 Payne
  2. Alan C Carver
    32 Carver