Palliative Care Always: INDIA

Course Director
Kavitha Ramchandran, MD
Palliative Medicine, Medical Oncology

Contributing Faculty
Ellen Brown, MD; Kelly Bugos, MA RN ANP-BC; Sandy Chan,
LCSW; Joshua Fronk, DO; Lynn Hutton, MSW;
Lori Klein, BCC JD MA; Judy Passaglia, RN MS ACHPN;
Manuela Kogon, MD

Course Description
Palliative care can help ease suffering and improve wellbeing in people living with a serious
illness such as cancer.

Palliative Care Always: India is a case-based course designed to help clinicians better
understand and practice the principles of palliative medicine—communication, symptom and
distress management, and addressing goals of care. The goal is to continue to improve quality
of life for cancer patients and their families in India.

Palliative Care Always: India features presentations from a variety of Stanford palliative
medicine clinicians as well as video scenes with a fictional patient living with colon cancer. The
course also includes forum discussions with other participants to promote learning from
colleagues’ experiences.

This course is ideal for clinicians, trainees and patients and families working and living with
cancer. This includes
• Oncology fellows and residents
• Advance practice providers
• Nursing staff and trainees
• Social workers and trainees
• Chaplains
• Health care volunteers
• Patients and families
Course Objectives
By the end of the course clinicians will be able to
• Describe the scope and role of palliative care as part of patient and family care plan
• Describe the components of an interdisciplinary treatment plan for physical,
psychosocial, and spiritual care, including screening, assessment and management of
patient needs
• Practice basic symptom and distress management and determine when to involve
palliative care specialists for extra support
• Describe the issues around transitions in care (e.g. hospice transition), and key needs for
patients and caregivers at these times
• Respond to common caregiver needs throughout the care continuum
• Practice effective communication skills with other healthcare providers, patients, and
their families; including responding to emotion, coaching in self-management of
symptoms and distress, and discussing goals of care

Course Structure
The course consists of 12 modules that each (a) addresses one aspect of palliative care in
oncology and (b) builds upon a foundation of communication skills introduced early in the
course. Modules include four components:
1. Reading and reflection – Participants review articles and media selected to provide
context and framing for the module topic and respond to an open-ended prompt.
2. Case Study: Sarah and Tim – Participants view a segment of the patient experience
through the story of Sarah Foster, a woman recently diagnosed with colon cancer.
Scenes reflect visits with relevant clinicians and illustrate communication skills and
palliative care concepts. Scenes are followed by a look at the experience of Sarah’s
husband and questions about the caregiver experience and strategies for responding to
caregiver needs.
3. Didactic lecture – Participants view dynamic lectures that cover basic assessment and
management of symptoms and distress as well as a introduce the scope of various
palliative providers (e.g., survivorship, chaplaincy)
4. Online forum discussion – Participants engage in guided forum discussion with their
peers in the course. Discussions include reflections on the patient and clinician
experience.
5. Focus on India - The objective of this section is to provide India-specific context to the
learnings from the Palliative Care Always. Within each module, an attempt has been
made to include the cultural nuances, family dynamics and policies & systems
influencing palliative care practices in India.
Course Length and Time Requirement
The course starts on April 14th 2019 (12:01 am PDT) and is available until October 14th 2019 at
11:59 pm PDT). Most participants move through the course one module per week and
complete the course in three months. Each module will take approximately 2 hours to
complete.

Course Outline
Module 0: Course Walkthrough
Module 1: Introduction to Palliative Care
Module 2: Communicating with Patients and Families
Module 3: Psychosocial Distress
Module 4: Goals of Care and Advance Care Planning
Module 5: Pain Assessment and Management
Module 6: Fatigue and Nausea Assessment and Management
Module 7: Survivorship
Module 8: Spiritual Care
Module 9: Psychological Care
Module 10: Caring for Children and Families
Module 11: Hospice Care
Module 12: Reflection and Self-Care

Assignments and Grading

There are four types of assignments included in this grade:
• 10% Reflections - There are 12 reflections at the beginning of each module based on articles
and media introduce the module topic. You must complete 10 of the 12 reflections.
• 10% Online forum discussions - The online forum grade is awarded for adding a post and
responding to a peer’s post, and then checking off the box below the prompt verifying that
you completed the exercise. You must contribute to 10 of the 12 online forum discussions.
• 30% Lecture assessment questions - There are 10 module knowledge checks consisting of
multiple-choice assessment questions that are based on the lecture content. The lowest two
knowledge checks will be dropped from your final grade to allow those who are not clinicians
to skip the symptom management modules (Modules 5 and 6).
• 20% Focus on India assessment questions - There are 11 module knowledge checks
consisting of multiple-choice assessment questions that are based on the readings and videos
in the Focus on India section. The lowest two Focus on India assessments will be dropped
from your final grade to allow those who are not clinicians to skip the symptom management
modules (Modules 5 and 6).
• 30% Final Exam – The final exam consists of multiple-choice questions based on the content
in the lectures.

A Statement of Accomplishment for this course requires a grade of 75% or more.

Course Support
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