Educational Conferences & Presentations

Varying geriatric topics, often including important palliative care and case discussions.

A weekly, interactive, quality improvement conference that often covers important end of life topics, challenging decision making, and communication issues. Internal Medicine residents present, and Dartmouth Hitchcock Medical Center faculty discuss the issues that arise.

Adult and pediatric case presentations with a focus on how caring for patients affects us and self-care. Run by Dr. Matt Wilson.

Varying medical and subspecialty topics.

MAT-ECHO is a learning community that enables a culture that understands addiction as a chronic disease and is prepared and capable to address a range of issues, including (but not limited to) clinical management, compassion fatigue, stigmatization, and mental health conditions that emerge during the process of treatment.

Project ECHO at Dartmouth Health leverages the experience, wisdom and expertise of healthcare personnel and community-based health supporters to advance meaningful learning and improved care of both individuals and communities. ECHO advances clinical care by bringing together primary care teams and specialists for brief didactics and highly interactive case-based discussions. ECHO advances community health by engaging schools, employers, libraries, community health workers and others with healthcare specialists and peers for similar interactive learning geared towards action. This series focuses on the care of people living in nursing homes or dealing with geriatric issues.

• Orientation to our team, including introduction to inpatient, clinic, JBC, social work, spiritual care, bereavement and volunteer program.
• Intro to Fellowship
• Intro to Hospice and Palliative Medicine
• Comprehensive Palliative Care Assessment (regional retreat)
• Pain Management Basics (regional retreat)
• Opioid Conversion Practice (regional retreat)
• Dyspnea and Cough (regional retreat)
• PCA Management and Adjunct Analgesics
• Nausea/Vomiting (regional retreat)
• Delirium (regional retreat)
• Constipation (regional retreat)
• Hospice 101
• Imminent Death Syndrome
• Compassionate Ventilator Withdrawal
• Methadone
• Therapeutic Cannabis
• Substance Use Disorder in HPM, Part 1 and 2
• Urine toxicology Interpretation
• Non-Oral Routes of EOL Medications
• Bereavement Risk Assessment and Grief
• Anxiety/Depression at EOL
• Ethics and ADs
• Artificial Hydration and Nutrition
• Requests for Hastened Death (regional retreat)
• Palliative Sedation
• Subanesthetic Dosing of Ketamine
• Mortality Review/Statistics in HPM
• How to Run an IDT
• Understanding Complex and Common Family Dynamics (quarterly)
• Legacy Work, part 1 and 2
• Critical Appraisal of Literature
• Prognostication
• Medication Assistance in Dying (regional retreat)
• Consult Etiquette in Hospice and Palliative Care (regional retreat)
• Moral Distress (regional retreat)
• Success as Independent Clinicians Panel (regional retreat)
• How to Teach - Tips and Tricks in Palliative Care
• Neuropathic Pain
• Billing in Hospice and Palliative Medicine (regional retreat)
• POLST Completion
• Working with Learners (regional retreat)
• Opioid Weaning
• Pain Crisis Management
• Introduction to Interprofessional Education and Learning (regional retreat)
• Yellowbelt Quality Improvement Science online training (8 hours)
• Pediatric SOS (regional retreat)
• Buprenorphine Primer (regional retreat) and Buprenorphine in Serious Illness Workshop (4 hours)
• Board Review led by faculty
• Symptom review and retrieval: cases, jeopardy
• Opioid risk assessment and mitigation
• Quarterly Case-based Learning for Pain Fellows and HPM fellows
• Patient Safety Investigation and Analysis: Understanding Mortality Review Processes in Hospitals
• Team Building and Conflict Management (regional retreat)

• Fellow Presentations
• Palliative Care ECHO®
  The Palliative ECHO® telementoring program is a monthly all-inclusive teach/teach learn/learn educational model. During these monthly sessions, a 15-minute didactic is presented by an interprofessional faculty member. A participant will present a challenging case and seek the wisdom from the community and core faculty during the remainder 45 minutes. The palliative care fellows will be mentored to present a case during one of the monthly ECHO® sessions.
  
  Read more about our innovative program in a paper titled A Triple Ripple: Palliative ECHO® Program Has Reverberations for Junior Faculty, Regional Health Care Colleagues, and Specialty Clinicians (PDF), written by one of our team Social Workers and Sectional Educators, Sasha Steinbaugh LICSW, and published in the Journal of Pain and Symptom Management .
• Patient Safety and Clinical Adverse Events Analysis Case Discussion
• Section Meetings
• Journal Clubs
• Visiting Discussants

Our fellowship offers an intentional and longitudinal communication training program.

Our curriculum utilizes role play, drills, and VitalTalk-powered communication coaching to teach progressive communication skills.

We use the Serious Illness Conversation Guide as a scaffold and work on specialty-specific skills that will allow fellows to excel in serious illness communication both clinically and academically.

Lastly, we assure fellows learn the principles and practice of being a communication coach to help educator others.

2023-24 Communication Training Series Sessions

• Holding Space
• Delivering Serious News - RE skills (regional retreat)
• Recognizing Information vs Emotional Cues
• Responding to Emotions (regional retreat)
• Responding to Emotions in the Resistant Patient
• Serious Illness Conversation Guide (SICG) Training
• SICG – Setting Up the Conversation
• SICG – Understanding of Illness
• SICG - Discussing Prognosis
• SICG – Goals Elicitation Part 1
• Goals Elicitation Part 2: Wise Mind and Listening for Inferences
• SICG – Making a Recommendation
• How to Run a Family Meeting: Taking all Perspectives into Account (regional retreat)
• Responding to Patients who Believe in Miracles (regional retreat)
• Responding to Patients who Request Hastened Death (regional retreat)
• Bedside Coaching Skills for Communication Educators - Powered by VitalTalk – 3 workshops on Pre-Briefing, Stepping In and Handing It Back, and De-Briefing
• Mastering Tough Conversations with the REMAP framework – Powered by VitalTalk (regional retreat)
• Bereavement calls

Regular sessions occur throughout the year during which learners come together with faculty to read short texts — including poems, excerpts from fiction and art — and respond to writing prompts. The sessions are designed to promote development of narrative skills that enable more effective "reading" of patients and their families. Sessions also allow fellows to practice reflection, perspective taking, and develop comfort with ambiguity and uncertainty.

Our Narrative Medicine sessions are co-facilitated by Dr. Kathryn Kirkland, who has extensive training in Narrative Medicine, and Dr. Chris Ahern.

Held approximately every 6 weeks, these meetings are designed to:

• Communicate feedback, received from program faculty, to the fellow
• Plan for talks, journal clubs or scholarly/QI activities
• Review patient logs and examine gaps in patient experience
• Offer personal reflection about the impact this work has on the fellow
• Provide job counseling

We spend 30 minutes of our interdisciplinary team meeting every Wednesday in a facilitated team discussion about a communication encounter that brought us to our learning edge. Both fellows or interdisciplinary faculty present, think through differentials, and brainstorm new communication strategies or skills with the larger team. You'll see this on your interview day!

We spend 30 minutes of our interdisciplinary meeting every Tuesday considering a current challenging case that we can have a more in-depth discussion about and get real-time input from various disciplines for next steps. Like a tumor board at a cancer center, we hope these recommendations can be put to use by clinicians after the meeting. Discussions often times focus on symptom management, system issues, or brainstorming resources.

Interprofessional faculty meet with fellows monthly to discuss a variety of topics pertinent to physician and advanced practice provider professional development in Hospice and Palliative Medicine (HPM). Topics have included curriculum vitae preparation; job applications, interviewing skills, scholarly work, the value of mentorship, leadership development, and pearls for early professionals in HPM. Previous alumni have joined sessions to talk about the lessons learned during their transition to practice. An additional session has been held with the APPs to discuss challenges and opportunities related to scope of practice.

It is the goal of the Palliative Care fellowship to foster peer-to-peer support in recognition of the unique and collective challenges and joys experienced by fellows throughout the year. We use a Mutual Aid model to develop an alliance of support among the fellows, which relies on a democratic-humanistic culture to cultivate a common cause or purpose that binds each fellow’s individual needs to the group’s needs. The Mutual Aid group is a place for problem-solving; sharing information, ideas, and resources; emotional support; and providing a safe haven for fellows to explore differences and experiment with new ways of thinking and practicing within Palliative Care.