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Clinician Educator Series
Feature Editors: Vicki Jacksonand Robert M. Arnold
Using Grand Rounds as an Instrumentof Culture Change
Vicki Jackson, M.D., M.P.H. and Robert M. Arnold, M.D.
Introduction
In this issue of the Journal of Palliative Medicine Drs.Morrison and Portenoy provide a detailed formula for
successful Grand Rounds presentations. They present ways tomake this time-honored method of teaching more relevantthrough the use of adult learning theory to increase the en-gagement of the learners.
An invitation to present a Grand Rounds devoted to apalliative care topic indicates a level of integration and ac-ceptance of our emerging field. It is critical not to confusethis integration with deep understanding of our clinicalpractice. It is surprising how many misconceptions con-tinue to exist such as conflating hospice and palliative careor that patients must be imminently dying to receive pal-liative care.
To address these misconceptions, all junior faculty shouldhave a Grand Rounds presentation that focuses on core con-cepts in palliative care. This can include topics such as thedifference between palliative care and hospice care, thehelpful diagram of inverted triangles representing the inte-gration of palliative care early in the care of patients, and theargument for why palliative care is necessary in modernmedicine. Depending on the audience, the focus can be clin-ical care, education, or quality and cost effectiveness. Manysenior faculty are willing to share their slides on these topics
so that junior faculty can develop an individualized talk thatmeets their specific needs.
When presenting a talk on giving bad news, for example,one can still include a few slides focusing on what palliativecare is, and how it can help promote clinicians to give badnews. Including the definition of palliative care and a slideclarifying common misconceptions, e.g., palliative care doesnot mean giving up hope, is critical in our ‘‘staying on mes-sage’’ as a field. Each Grand Rounds presentation is anopportunity to change culture by educating others aboutpalliative care.
Drs. Morrison and Portenoy suggest many ways to makethese often dry presentations engaging and dynamic. Use ofthese techniques is critical to the development of a successfulGrand Rounds presentation and will get junior faculty off to agood start as they begin to educate others and represent thefield.
Address correspondence to:Vicki Jackson, M.D.
Palliative CareMassachusetts General Hospital
55 Fruit StreetBoston, MA 02114
E-mail: [email protected]
JOURNAL OF PALLIATIVE MEDICINEVolume 13, Number 12, 2010ª Mary Ann Liebert, Inc.DOI: 10.1089/jpm.2010.9754
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