Education

UNIPACs are Becoming Essential Practices in Hospice and Palliative Medicine

AAHPM’s top selling self-study series, UNIPAC, will be receiving a face lift in 2017. The UNIPAC is being rebranded and will be called Essential Practices in Hospice and Palliative Medicine, but will still be featured as the popular 9-volume set with newly updated content and practical cases.

The content of each book has also been reorganized into the following titles:

  1. Medical Care of People with Serious Illness
  2. Psychiatric, Psychological, and Spiritual Care
  3. Pain Assessment and Management
  4. Nonpain Symptom Management
  5. Communication and Teamwork
  6. Ethical and Legal Practice
  7. Pediatric Palliative Care and Hospice
  8. COPD, CHF, and Renal Disease
  9. HIV, Dementia, and Neurological Conditions

View our latest YouTube video on the new Essential Practices in Hospice and Palliative Medicine to gain further insight into the new edition.

Currently, all UNIPAC, 4th edition books are 50% off using promo code UNIPAC50 in the store. Get yours while supplies last! This deal lasts until June 30. After June 30, they will be gone for good.

Quick Take on the 2017 Medicare Physician Fee Schedule: 5 Things You Should Know

By Phillip E. Rodgers, MD FAAHPM
Co-chair, AAHPM Public Policy Committee and Quality-Payment Working Group
AAHPM Representative, American Medical Association/Specialty Society Relative Value Scale Update (RUC) Advisory Committee

On Nov. 15, the Center for Medicare and Medicaid Services (CMS) published the 2017 Medicare Physician Fee Schedule (PFS) Final Rule. (Access a CMS Fact Sheet.)  Each year, the PFS designates how  – and how much – physicians and eligible billing practitioners get paid through the Medicare Part B program, which continues to cover roughly 70% of all Medicare beneficiaries (and many, if not most, of the patients seen by palliative care teams).

In recent years, AAHPM has been collaborating with specialty society partners and meeting with CMS officials to advance new codes that value non face-to-face work and more appropriately recognize the work of coordinating care for complex patients. So we were very pleased to see that earlier this year CMS proposed to include some of these codes in the PFS and make other significant changes that could positively impact palliative care teams. (Read AAHPM’s comments on the Medicare PFS proposed rule.) Nearly all of these proposals were just finalized and will become effective Jan. 1.  While it will take a few weeks to fully digest all the details in the final rule, here are five key changes for 2017 that you should know about:

1) New Payment for Advance Care Planning Services Provided via Telehealth. For those of you providing CMS-approved telehealth services (and you know who you are), you can now use the advance care planning (ACP) codes to bill for ACP services. While currently limited to patients in rural or health professional shortage areas, telehealth may expand significantly in the future.

2) 30% Increase in Payment for ‘Prolonged Face-to-Face Services’ in the Outpatient and Home Settings. Many HPM clinicians use prolonged face-to-face services codes to describe services like extended family meetings, time-intensive symptom management, and complex medical decision making. In 2017, payment for prolonged F2F services in the outpatient or home setting only, will increase by 30 percent.

3) New Payment for ‘Prolonged Non Face-to-Face’ Services. Starting in January 2017, Medicare will start making payment for significant ‘non face-to-face’ time spent in activities like reviewing patient records or interacting with referring clinicians, families, and interdisciplinary team members in preparing for (or following up on) an E/M visit in the hospital, clinic or home setting.  This is a potential game changer. As long as code requirements are met (e.g. at least 30 minutes spent on a single day, which may or may not be the same day as the related E/M code), billing practitioners can now get paid for this valuable and previously unreimbursed time.

4) New Payment for ‘Complex’ Chronic Care Management. Starting in 2017, Medicare will now start making payment for ‘complex’ chronic care management codes (CCCM):  99487 (first 60 minutes) and 99489 (each add’l 30 minutes). These codes reimburse time spent by non-billing clinicians (RNs, LPNs, medical assistants, social workers, spiritual care providers and others) in care outside face-to-face visits. Compared to the existing chronic care management code (99490, billable just once a month), these codes describe more involved services for more complex patients.  They also pay at a significantly higher rate and can be billed as many times as necessary to reflect the time spent during a given month.

There are important details about these services (beneficiary consent, cost-sharing, etc.) which need to be considered but, for palliative care teams that are providing care coordination services to their patients, this could be a significant source of new revenue to help support the interdisciplinary team.

5) New Codes and Payment for Behavioral Health Integration and Cognitive Impairment Assessment and Management. These are two big, new additions to the PFS that describe and value the work of psychiatric collaborative care (using psychiatrists and behavioral care managers in primary care practices) and assessment of cognitive impairment and dementia (which, notably, has a requirement to address advance care planning and palliative care needs of patients with cognitive impairment). These code sets have many moving parts and are worth getting to know well, particularly if you or others in your organization provide these specific services.

More importantly, these additions signal Medicare’s willingness to work closely with the provider community to break new ground in describing and paying for patient-specific, non-procedural services and could lead the way to describing other services (like, for example, palliative care assessment and management).

Well, if you’ve made it this far, bravo!  You may also be thinking:  Why should I care about this stuff, or the Medicare PFS at all?  It seems very complicated, confusing, and difficult to keep track of in my busy clinical life.  And isn’t fee-for-service dying anyway? Valid points, but I’ll leave you with two reasons to care.

First, fee-for service payments from Medicare (and the vast majority of commercial payers who follow Medicare’s lead) remain big sources of professional fee revenue for palliative care providers.

Second, while we are clearly moving to value-based reimbursement, the architecture of the PFS will remain very pertinent. The majority of the changes coming with implementation of Medicare’s new Quality Payment Program—through the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) pathways—are built on a fee-for-service chassis. This is intentional, and not only allows a smoother transition to new payment models but also retains what is still our best (if very imperfect) system to describe and value the work of clinicians caring for patients and families.

The 2017 Medicare PFS Final Rule makes measureable progress in this regard, and so deserves our attention. Review it with your favorite billing colleague or consultant, and see how you can take advantage of its new opportunities. In the meantime, AAHPM will both continue to work with stakeholder specialty societies to advance reimbursement for high-value, cognitive care services not currently described or paid for under the PFS as well as engage HPM thought leaders to support an Academy strategy aimed at advancing palliative care in emerging payment models.

Research & Retreats: An Inside Look from AAHPM President Christian Sinclair

Each year, AAHPM awards a number of scholarships to deserving individuals to attend the Annual Kathleen M. Foley Palliative Care Retreat & Research Symposium through the Research Scholars Program. Congratulations to our 2016 recipients! Gain an insider’s view of the retreat from current AAHPM President Christian Sinclair.

_____________________

During this year as president of the American Academy of Hospice and Palliative Medicine (AAHPM), I am privileged to hear about many of the great things happening in our field. This past week I attended the Kathleen Foley Palliative Care Retreat and Research Symposium in Quebec City where junior and senior researchers gathered for education, networking and mentorship.  Dr. Sean Morrison and the National Palliative Care Research Center (NPCRC) were responsible for convening this grand meeting as they had done for the past nine years.  This year’s co-sponsors included the American Cancer Society (ACS), AAHPM, the Hospice and Palliative Nurses Association (HPNA), Gordon and Betty Moore Foundation, and Emily David and Joseph S. Kornfeld Foundation.

Like many of you, I am not a researcher, but I do consider myself quite a big fan of research, as it helps establish the foundations for our interventions and ability as a field to change systems of care. The researchers invited were a diverse group of nurses, psychologists, social workers and physicians holding grants supported by the NPCRC and ACS, research scholarships from AAHPM and HPNA, and other leaders, investors, and supporters of the field of palliative care.

During the two days of content, the approaches to learning were varied, from classic didactics from Vincent Mor, Ab Brody, Susan Mitchell and others, to the poster presentations and work-in-progress sessions from many of the junior investigators. Names that you recognize from articles like Tulsky, Arnold, Temel, Ritchie, Kutner, Teno, Ferrell, Mor, Mitchell, Wolfe and others were there to give feedback to early- and mid-career researchers as they presented their work. The camaraderie and mutual admiration was evident from the many conversations I observed and participated in.

One of the big themes at this 10th Foley Retreat, was looking to the future. The NPCRC had already accomplished many of the early goals of creating a stronger research pipeline through support of early-career scientist-clinicians, yet open discussions were held to best plan for the future in an ever-shifting funding landscape. Many felt that the support from the NPCRC and aligned organizations (like AAHPM and others) was critical to maintaining the momentum by helping palliative care researchers get started wherever they are, especially when there are only a handful of institutions able to crank out the studies we need as a young field.

Like the opportunity to visit with those preparing for the boards and hospice medical directors at this year’s Summer Institute, I am very appreciative to see the diversity of professional focus in hospice and palliative care. At the heart of these experiences is fellow hospice and palliative care clinicians supporting each other, which is one of the reasons I love this field and support the Academy.

The Faculty’s Top 5 Reasons to Attend the AAHPM Board Review Course

The Summer Institute will be featuring an Intensive Board Review Course on July 25-27 in Pittsburgh, PA. Get ready for your Hospice and Palliative Medicine board certification examination by experiencing this redesigned program which includes didactic presentations, interactive sessions and exam-style questions.

1)      You’re awesome.  Let’s face it, other fields may have some nice folks, but I’ve never meet a community like AAHPM.  Where else are you going to meet hundreds of bright, articulate, and compassionate people with well-honed listening skills?  Find friends and colleagues that you’ll enjoy seeing throughout your career.  It’s time to meet your tribe, and your tribe is exceptional.

2)      “This is only a test.”  Beyond a few hours of clicking answers, possessing deep understanding of your field and of the human experience will offer personal and professional benefits throughout your life.  Prepare for the REAL test – the test at the bedside. Mastery of hospice and palliative medicine comes with interacting with the material and challenging yourself and your colleagues.  Start your career strong!

3)      It’s not for everyone.  You know that lucky person who got to see the stadium-packing rock band in an intimate venue 20 years ago?  This is your one-time chance to spend a full day in an intimate setting, having direct interaction with palliative care experts.  While the larger annual assembly offers packed conference rooms and lots of excitement, this is something far different: an opportunity to be up close and personal.

4)      Improve your chances.  There are many joys of practicing in hospice and palliative medicine.  Sitting in a testing room is not one of them.  Do this well and do this once!

5)      Pittsburgh.  Yes, really.  This a great American city that is too-often overlooked.  Enjoy the panoramic views from the Dusquene Incline.  Join us for a Pirates game, visit the Andy Warhol Museum, or enjoy the waterfront trail loop at Three Rivers Park.  Beauty and wonder are there to be found if you only take the time to look.

The early bird rate ends Tuesday, June 28. Register now and save!

Pittsburgh. Mighty. Beautiful.

According to Trip Advisor, there are 162 exciting things to do in Pittsburgh. We know you won’t have time to do them all since learning will be your priority at the AAHPM Summer Institute July 24-27, but we thought you may want to see what the top 10 things are:

  1. PNC Park “Best ballpark in the US.”
  2. Phipps Conservatory “Museum Bucket List.”
  3. Mount Washington “Best view of Pittsburgh.”
  4. Bicycle Heaven “Rare find – loved It!”
  5. Carnegie Museum of Natural History “Kids love the dinosaurs!”
  6. Heinz Field “Iconic and windy (always).”
  7. Duquesne Incline “A must do and get a panorama of the city.”
  8. Senator John Heinz History Center “Awesome exhibits!”
  9. The Strip “Perfect place to shop.”
  10. Consol Energy Center “State of the art hockey venue.”

Consider bringing your family or friends to enjoy this great city. Learn more at www.visitpittsburgh.com or follow @vstpgh on Twitter and Facebook.

A Fellowship Does Matter

I entered my Palliative Care and Hospice Fellowship in July of 2014, having previously weighed the benefits and burdens of grandfathering in vs. fellowship training. Encouraged by colleagues and my employer I hoped to pursue an experience that would be richer than on the job training and book learning. I did my research before applying to programs. I asked a lot of hard questions to my potential programs. My program director questioned me about what I would want to accomplish since I was already a Hospice Medical Director and had years of physician experience. I laid out my goals and eagerly anticipated the start of my year of learning. Now I am confident that the value of my experience needs to be shared so that other contemplating such a move can be reassured.

I knew it was not going to be easy to move my established life. I resigned from my clinical and administrative positions. I said goodbye to many wonderful coworkers, and patients. I packed my bags and returned to life as a student. My medical career has always been about caring for populations at risk. I embraced the growth that comes from ongoing transitions in my medical career.

I quickly was amazed by the talent of my co-fellows and attendings. As palliative care and hospice providers, we learn amazing skills and invaluable tools for patients in need of care and compassion. Now I realize that I am past the eleven months mark and the time has flown. The experience of my fellowship year has far exceeded my expectations.

I now know how to manage patients and families who appear at the doorsteps of a busy inpatient unit in the worst of situations. I understand the dynamics of highly trained interdisciplinary teams when providing for the physical and emotional needs of patients with advanced suffering. I have learned to palliate the terrible suffering in bodies that cease to sustain themselves. I can feel the deep gratitude as families leave us through the same entrance that greeted them only hours or days earlier.

I have worked in multiple palliative care settings, from solo physicians to full interdisciplinary teams. I have gathered the wisdom of the physicians and other team members to maximize communication across the many levels of human despair. I have gained wisdom from hearing and contrasting multiple attendings’ approaches on symptom management. I know about triaging scarce team resources, the dance of consultant etiquette, and the need to enhance the primary physician’s relationship with the patient.

We care for more than just the patients and their families. We serve and care for the entire range of hospital staff: from medical students to attendings, from CNAs to directors of nursing. We support and coach the new social workers trying to grasp the nuances of hospice placement. We continue to define our role and our skills within hospital systems that barely have time to breathe and reflect. We respect and serve our patients and their families. We advance the science of palliative medicine as we gather data that shows our value to administrators eager to improve quality, satisfaction, and cost savings. All in all, we do great work.

I have grown personally and professionally in ways I never imagined. The need to be in a fellowship is reinforced every day. The year of intense experience is balanced by the beautiful and unwavering support of the attending faculty. The confusion of new places and new rotations is organized and simplified by amazing support staff. When we feel lost, we are given a path and encouragement. When we stress, we are given support and relief. When we look to the future, we are prepared for change and reminded that our mentors are always there for us.

This experience has transformed my initial goals, allowing me to envision the future of palliative care. I see myself able to work in all of the settings of hospice and palliative care. In our developing specialty I see myself returning not only to clinical work but also to a position of leadership and advocacy. I see a great opportunity for supporting teams during the explosion of need for palliative care across the continuum of health care. I hear the warnings about burnout in hospice teams and palliative care teams that need to stay strong now more than ever. I see the need for networking and support among our professions at all levels.

My program is supporting me in my quest to learn about business strategies for hospice and palliative programs. I am actively connecting with our national and international organizations. This amazing fellowship has given me and my co-fellows an environment, a model, and a vision of how to care for patients, families, coworkers, healthcare teams, and ourselves. I am excited because I now see vast opportunities in my life. I look forward to working with hospital systems and healthcare systems as our profession carries forward the recommendations from the Institute of Medicine’s recent report on Dying in America. It is clear to me that this transformation and world of opportunities would have been missed if I simply grandfathered in to board certification. I will forever be thankful that I chose this fellowship experience.

Whit Dunkle, MD, ABFP
Medstar Washington Hospital Center/Capital Caring Fellowship

ICD-10 Program Focusing on Hospice and Palliative Care

Dear Education Colleagues,

Are you familiar with all the ICD-10 changes coming your way? Are you certain exactly where to find morphology codes? What has the 8-week rule regarding initial and subsequent MIs changed to? How does laterality effect your coding? How will you correctly code for symptom treatment? What about the management of terminal illnesses with related conditions? Discussions will include the significant advancements between ICD-9 and 10, the newly created complex guidelines encompassing codes, rules including Laterality, Encounters, Activity, and Place of Occurrence. The newly created ICD-10 structure accommodates both technological and medical advances and, allows for more flexibility with the highest level of specificity and clinical detail. New features include the relocation of the Neoplasm Table and why the Hypertension Table is no longer necessary.

We will answer your questions, address your concerns, and teach you the myriad of changes with respect to new laws and requirements in Hospice and Palliative Care at the ICD-10 Boot Camp for Hospice and Palliative Care.

October 1st is fast approaching, let us lead you to Your Success for ICD-10!

Jean Acevedo, LHRM CPC CHC CENTC
Acevedo Consulting Incorporated

Education Resource Email #6: Intensive Talk

Dear Education SIG Colleagues,

Over the years, many of you have likely become familiar with or participated in Oncotalk and similar courses (e.g. Geritalk, Critical Care Communication Course, Nephrotalk) aimed at improving communication skills of trainees. Through palliative care fellowship and early career development, I felt like I had developed the target communication skills of these courses. However, as an educator, I struggled to pass these skills on to trainees, relying mostly on modeling and discussion. I have yearned to develop a more robust repertoire for teaching communication skills.

IntensiveTalk was a program which fulfilled these faculty development goals for me. Through IntensiveTalk, I developed a deeper understanding of the use of small group teaching and simulation to teach communication skills. IntensiveTalk was led by a group of expert palliative care communication educators/investigators through VitalTalk (http://vitaltalk.blogspot.com/) who also recently directed a similar faculty development program, Pallitalk. Since there will likely be similar faculty development programs in the future, I thought it would be helpful to share some information about the IntensiveTalk Course.

The IntensiveTalk course was comprised of 2 three day retreats in Pittsburgh. Ten different institutions were represented, with each institution sending a palliative care faculty member along with a critical care faculty colleague. Before the course, I was curious about how this mix of palliative care and critical care faculty would work. How would the investigators make sure that everyone was on the same page about the target communication skill-set? Would there be noticeable differences between the two specialties which would interfere with development of the teaching skills? This concern quickly became negligible, and I think the structure of the first retreat largely played a role in this:

     1. Day 1: Through a combination of large group and small group sessions, faculty participants learned about target communication skills for giving serious news and redefining goals of care. The two small groups were each an equal blend of palliative care and critical care faculty. In the small group sessions, faculty participants took part in simulated family meetings with trained actors. These sessions served as a way to ensure that each faculty participant understood the target communication skills, gave participants an introduction to the teaching method, and also provided a sense of what it’s like for learners to take part in the teaching method (e.g. what it’s like to be in the “hot seat” talking to a simulated patient or family).

     2. Day 2: On this day, the focus pivoted towards the skills necessary for facilitating the simulations from day 1. The “learner hot seat” was now inhabited by a “simulated fellow” and the participants now took their place in the “hot seat” as a facilitator. The investigators provided a facilitation roadmap, and each participant was given opportunities to practice key steps in the roadmap (such as helping learners to set goals, how to use time-outs to effectively debrief, and eliciting take-home points from learners). To further emphasize the importance of the facilitation roadmap, the investigators continued to use this roadmap to facilitate participants as they learned the roadmap and target facilitation skills!

     3. Day 3: This day offered further opportunities to practice facilitation followed by a session for each institutional dyad to consider their plans for developing educational sessions at home.

In between retreats, there were frequent emails amongst group participants, allowing a chance for each dyad to share their successes and challenges as well as obtain feedback.

The second retreat offered opportunities to consolidate facilitation skills, learn about small group teaching dynamics, and more helpful sessions on developing simulation courses.

     1. Day 1: In addition to offering further opportunities to practice small group facilitation skills, this day offered an opportunity to do brief drills which isolated common challenges which learners might present (e.g. the learner who has difficulty identifying a learning goal, the anxious learner, the skeptical learner, etc).
     2. Day 2: More small group practice on small group dynamics issues (e.g. when learners are disruptive, etc). There were also sessions focused on course development (e.g. eliciting support from your institution, budgeting, etc).
     3. Day 3: This day focused on actor training, including an opportunity to practice training an actor for a new simulation.

Interspersed throughout the course were sessions which focused on educational theory, time for reflection on professional goals (as both a clinician and educator) and community development. By the end of the first retreat, it felt like we were part of a cohesive community, and distinctions between palliative care and critical care dissolved.

Because of the extent of non-ideal communication I observe on a daily basis in my practice setting, this has frequently resulted in a desire to prompt a sea change in practices. An “a-ha” moment for me as a participant was when I realized that this sea change cannot and will not come instantly under any circumstance. Sea change comes through identification of a personal “learning edge” and making one small change at a time (akin to continuous quality improvement). In addition, amidst the miscommunication, we need to provide ample positive feedback for things which learners already do well.

The teaching methods I learned through this course have already helped me better teach communication skills at my institution. The course played a significant role in the development of a local three day course for critical care fellows, led by my critical care colleague and me.

A nonprofit with the mission of nurturing healthier connections between patients and clinicians, VitalTalk continues to look for opportunities to provide similar faculty development programs for educators. Keep your eyes peeled for similar opportunities! You can sign up for email notifications from VitalTalk and follow them on Twitter (see their website: http://vitaltalk.blogspot.com/ ). Feel free to contact me with questions about IntensiveTalk.

For more information on the teaching methods, see Fryer-Edwards, K., et al. (2006). “Reflective teaching practices: an approach to teaching communication skills in a small-group setting.” Academic Medicine 81(7): 638-644.

Cheers,
Lyle Fettig, M.D.
Assistant Professor of Clinical Medicine
Indiana University School of Medicine
1001 W. Tenth St. OPW M200
Indianapolis, IN 46202
Pager- (317) 310-7988
Phone- (317) 630-7061
lyfettig@iupui.edu

Education Resource Email #5: Fast Facts and Concepts

Fast Facts and Concepts for Ed-SIG

http://www.eperc.mcw.edu/EPERC/FastFactsandConcepts

Fast Facts and Concepts (“FF”) are a series of short, peer-reviewed monographs on a wide variety of palliative care topics. They are published on the EPERC website at the Medical College of Wisconsin, as well as co-published in the Journal of Palliative Medicine. FF were started in around the year 2000, as part of the Robert Wood Johnson Foundation palliative care residency education project that David Weissman MD ran. Drew Rosielle MD has edited them since 2007, with assistance from Sean Marks MD since 2013. More information about the editorial board and process is available on the FF website.

Using FF as an educational-resource.


  1. FF are developed to be practical & clinically relevant point-of-care resources. We write/edit them with residents in mind, although we hear that they are used widely by medical students, residents, attending & faculty physicians, nurses, social workers, and administrators. They are aimed at non-palliative specialists, but would be relevant for palliative learners such as fellows, especially in the first 6 months. The idea behind FF is to give the reader both a broad overview of a topic, as well as practical tips in approaching a patient or certain situation, whether it is extubating a patient to ‘comfort care,’ going into a family meeting one worries is going to be contentious, to seeing a cancer patient in clinic who complains of severe fatigue.

  2. FF are based in evidence, as well as evidence-based. While always peer reviewed, as FF (and the field of HPM in general) evolved, it became more important for them to be evidence-based. The current editorial stance is that they have to be as evidence-based as much as there is evidence, and transparent about the level of evidence behind any recommendation. That said, much of our practice remains empiric, and we continue to believe there’s a role for common sense and the wisdom of clinicians, and FF include a lot of that, as well. They are ‘evidence-based,’ insofar as they’ve been investigated and shown to improve medical resident’s palliative knowledge (http://www.ncbi.nlm.nih.gov/pubmed/21395446).

  3. Ideas for using them as teaching tools:

    1. When working with learners on, for instance, a palliative consult service, have them pull 2-3 relevant FF for each new patient they see and share them with peers on the team each morning after rounds (etc).
    2. Use them for ‘academic detailing.’ A colleague asks you why you do something, give them the FF as a starting point.

  4. FF for fellows:

    1. FF are peer-reviewed, and published in an indexed journal, and are great scholarly project for fellows. Ask anyone who has written one, the editorial process for them is demanding and meticulous.
    2. If a fellow is interested in writing one, please make sure they contact Drew Rosielle (rosielle@umn.edu) before starting. There are 10+ being worked on at any given time, and so fellows should make sure it’s not a ‘spoken-for’ topic before starting work.

Education Resource Email #4: PalliTalk

Dear Education SIG members,

Welcome to the first new Education SIG Resource Email of the year. This email provides further information on “PalliTalk” which you heard about in an email on this listserve last week.

PalliTalk is a train-the-trainer course for palliative care faculty interested in learning to teach communication skills to their fellows using simulated patients. The course will be held in Aspen, Colorado at the Aspen Meadows. The dates for the course are: September 30-October 3, 2013. The course is partially funded by a donor who wants to ensure that every HPM fellow receives intensive communication skills training during their fellowship.

The course has been created by Tony Back, Bob Arnold, James Tulsky and Kelly Edwards. This team, along with Walter Baile, developed Oncotalk back in 2002. For those unfamiliar with the program, Oncotalk was a communication skills training retreat for oncology fellows that showed impressive results in terms of how it was able to change behaviors (Back AL et al. Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Arch Intern Med. 2007; 167:453-460). This program ran from April 2002- October 2004. The same team followed this program with Oncotalk Teach, a train-the-trainer course for oncologists that focused on teaching oncologists how to teach their fellows about communication during real patient encounters. Several other courses created either by this same group or by the junior faculty involved in these original projects are now up and running including: Intensive Talk, GeriTalk, WeTalk, and Nephro Talk. Now, after all of this work focused on other fields, Palliative Care finally gets its own national faculty development program with PalliTalk.

As mentioned in the email from earlier this week, I am one of the faculty for PalliTalk. Besides giving further information about the program and its history, I thought it may be helpful to use this email to share my experience with these programs. When I was a fellow, I attended the original Oncotalk as a learner. My program director encouraged me to go and, while I loved the idea of an all-expenses paid trip to Aspen, the idea of doing role-play for a week was less attractive. I had always hated role play and did not find it helpful. What I experienced at Oncotalk, however, was a completely different role play experience. It felt safe and it was focused on what I wanted to learn. I could see myself gaining skills as I tried new things. And, unbelievably, it actually became fun! This was a transformative experience and I have since focused my career on this type of teaching, working on several of the courses mentioned above, including Oncotalk Teach and WeTalk. I find it so rewarding as a teacher because every session is different and challenging and you get to watch your group grow, learn and change before your eyes.

What you can expect at PalliTalk is an introduction to this model of teaching communication skills. The majority of the time will be spent in small groups practicing your own teaching. You will essentially be role playing how to run a role play. You will identify your learning goal as a teacher, you will then try running a role play and will time out when you get stuck. You will identify where you were stuck and will brainstorm with your group and then you will get the opportunity to try a new approach and see how it works differently. As we’ve seen in other similar programs, we expect that, by the end of the week, you will feel empowered by the new teaching skills you have worked hard to gain.

If you missed the email from earlier this week, here is the information again:

PALLITALK

A unique train-the-trainer conference that will equip Palliative Care faculty physicians to run small group communication skills training workshops for their fellows. Using evidence-based methods based on expertise acquisition, you will experience the learning model we developed in Oncotalk, then learn the small group facilitation techniques we use. We’re aiming this course for physicians who could run a short workshop for their Palliative Care fellowship program. We encourage 2-person teams because the f2f co-mentorship accelerates your development.

4 days of learning and networking in beautiful Aspen -Monday, September 30, 2013 at 8:00 AM – Thursday, October 3, 2013 at 5:00 PM (MDT)

The faculty will include Anthony Back, Bob Arnold, James Tulsky, and Kelly Edwards, who have been working together for over a decade. Other faculty include Gordon Wood and Holly Yang (watch our blog for updates at vitaltalk.blogspot.com).

Details: The tuition for the course is due 30 days prior to the course and will be $1000 for the four-day course. This includes lodging, breakfast, lunch and two dinners. This course is being supported by a donor. In the next iteration, the cost will be much closer to the market value of the course. The $100 ticket fee holds your spot and is nonrefundable. We’re limiting the course to 24 participants, so apply now!

APPLY TODAY at http://vitaltalk.eventbrite.com

Please feel free to contact me or any of the other faculty with questions.

Gordon

Gordon J. Wood, MD, MSCI, FAAHPM
AAHPM Education SIG Chair-Elect