HLTH6179 Specialist Practice in Cancer, Palliative and End of Life Care
This module will enable you to lead practice in complex and challenging situations in the care of people with cancer in all stages of their illness, or with palliative or end of life care needs arising from any illness. It will also equip you to support and develop other practitioners providing this care. The aspects of advanced level practice considered in this module are those related to provision of clinical/direct care. The module will develop your depth of knowledge about complex care and your reasoning skills. It will also equip you to develop others by promoting a culture that fosters continuous learning and development (Department of Health UK 2010)
Aims and Objectives
1. Debate the nature of clinical leadership in cancer, palliative or end of life care 2. Appraise the evidence-based therapeutic care required by those with cancer, palliative or end of life care, taking account of the impact and meaning of illness and therapy 3. With reference to clinical education theory discern the leadership required to create sensitive work environments that promote and sustain professional development 4. Reflect critically on your leadership in relation to meeting patient needs and the needs of the team involved in their care: • evaluate the evidence and theories underpinning your decision-making • debate the ethical and legal positions influencing your leadership • analyse the socio-contextual factors influencing your leadership • identify your learning and draw implications for your future practice 5. Communicate skilfully with patients, family members and colleagues: • who are distressed • to undertake a holistic assessment and anticipatory or advanced care planning • to provide 1:1 support that fosters partnership • to promote learning and professional development of colleagues • to influence research agendas and the clinical implementation of research
Having successfully completed this module you will be able to:
- Debate the nature of clinical leadership in cancer, palliative or end of life care
- Appraise the evidence-based therapeutic care required by those with cancer, palliative or end of life care, taking account of the impact and meaning of illness and therapy
- With reference to clinical education theory discern the leadership required to create sensitive work environments that promote and sustain professional development
- Reflect critically on your leadership in relation to meeting patient needs and the needs of the team involved in their care: • evaluate the evidence and theories underpinning your decision-making • debate the ethical and legal positions influencing your leadership • analyse the socio-contextual factors influencing your leadership • identify your learning and draw implications for your future practice
- Communicate skilfully with patients, family members and colleagues: • who are distressed • to undertake a holistic assessment and anticipatory or advanced care planning • to provide 1:1 support that fosters partnership • to promote learning and professional development of colleagues • to influence research agendas and the clinical implementation of research
The nature and scope of specialist and advanced practice in cancer, palliative and end of life care - locally, nationally and internationally and the attributes of clinical leadership – professional and lay perspectives, values, definitions, philosophies, service organisation and implications for clinical leadership 1 The impact and meaning of illness for individuals and family members, across the life-span – narrative and biographical accounts, theoretical explanations, temporal and critical moments in illness (diagnosis, treatment, prognosis, survivorship, recurrence, dying, bereavement) 2 The impact of cancer and non-cancer illness on health – physical, mental, social, occupational, developmental and spiritual impact in the moment of illness and over time (e.g. long term consequences of treatment) - impairment, symptom expression, assessment and management - pharmacological and non-pharmacological, treatments, physical, occupational, art/music therapies, psychological interventions, family, social and faith support 2 4 Maximising the potential for and facilitation of self-management – therapeutic approaches that maximise an individual’s ability to participate in and lead their own care, definitions of self-management, application of self management at different time points in illness – e.g. health promotion to encourage early detection of illness to advanced care planning for the end of life 1 2 3 4 Provision of therapeutic care in these specialities – assessment, intervention, evaluation and governance – definitions of therapeutic care, theoretical explanations, debate re contextual influences on care and on staff experience, discipline and cultural interpretations and strategies for such care 2 3 Communication skills – the narrative templates of everyday conversations, application to clinical conversations, analysis of skills needed for effective communication, skills rehearsals in recognising concerns, recognising distress, demonstrating empathy, exploring possible strategies, facilitating problem-solving, negotiating action plans, preventing further psychological harm. Skills related to holistic assessment and care planning. 5 Clinical Relationships Self as a leader – self-concept of student in relation to leadership, personal values, scope of influence, leadership approaches adopted, imagining other ways of being a leader 4 Self as a team leader – leading, motivating and inspiring others, ethics of leadership, professional and cultural expectations of leadership and leadership roles 4 5 Developing and supporting others – inspiring and educating, collaborating, influencing – critical consideration of major leadership and education theories 45 The relationship between leadership and patient and family care 2 4 5 The relationship between leadership and effective team work 3 4 Clinical consultancy – working with others to influence care provision 3 4 Clinical interpretation of policy and research: Discriminating sources of evidence influencing clinical decision making and appraising appropriateness of evidence available 1 2 Understanding research process and the inter-relationship between clinical practice, research and policy 2 3 4 Research approaches that attend to illness experience and clinical interventions (narrative, biography, phenomenology, RCTs) and healthcare experience 2 Influencing a research sensitive clinical environment – process of implementing research outcomes 1 2 3 Research ‘landmarks’ in cancer, palliative and end of life care relating to the experience of illness and clinical interventions e.g. non-pharmacological management of symptom distress; early recognition of illness. 2
A particular feature of this module is the way is which it integrates work-based experience and learning with the taught and student-directed activities in order to be relevant to your practice, the needs of the practice area and the development of academic skills commensurate with the module and programme learning outcomes. The clinical development features of the module will be facilitated by a module team who have extensive clinical experience in cancer, palliative and end of life care. The communication skills development of the module will be addressed through performative strategies such as forum theatre, rehearsals and simulated practice examples. These examples may include managing difficult and distressing conversations, undertaking holistic assessments, providing 1:1 support and anticipatory or advanced care planning and developing others. This will be followed by group generated reflection in the classroom that is posted within the virtual learning environment. The module also provides you with the opportunity to be exposed to practitioners working in a range of disciplines, with a range of conditions or age groups. This opportunity will be capitalised upon in discussions about the specialist nature of cancer, palliative and end of life care, the nature of clinical leadership and of research in these specialties. There will also be opportunities for you to focus on your particular discipline, specialty and the needs of your client age-group with field and discipline experts.
Learning and Teaching
Teaching and learning methods
The module will be taught in two small blocks of two days, separated by four weeks in which you will undertake negotiated work related learning. The taught programme will consist of: key-note papers, workshops, case-discussions, master-classes, tutorials and student-led seminars. The negotiated work related learning will consist of: Four days of observation activities in practice or negotiated observational visits designed to enhance your clinical leadership in practice, such as: benchmarking your practice against specialist and advance practice descriptors appropriate to your role and professional development and specialist focus; detailed observation of your practice by yourself and peers; critical reflection of your practice; observing your leadership practice in relation to its responsiveness to facilitating other people’s professional development; observing clinical education activities and educational strategies used by disciplines or organisations different to your own; Reflection on & analysis of work based experience (4 days), including reflecting on your team work and generation of an action plan to inform your future development. These will be supported by web-based and library resources, e-learning resources and tutorials with your personal academic tutor.
|Wider reading or practice||150|
|Total study time||375|
Resources & Reading list
Department of Health (2011). Spiritual care at the end of life: a systematic review of the literature.
Forsetlund L, Bjørndal A, Rashidian A, Jamtvedt G, O'Brien MA, Wolf F, Davis D, Odgaard-Jensen J, Oxman AD. (2009). Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews Issue 2. ,Art. No.: CD003030 , pp. 0.
Firth-Cozens J and Cornwell J (2009). The point of care: Enabling compassionate care in acute hospital settings.
Gringer A (2002). Cancer in young adults: through parents’ eyes.
Sontag, S. (1978). Illness as Metaphor.
Kleinman, A. (1988). The Illness Narratives: Suffering, Healing and the Human Condition.
The National Cancer Patient Experience Survey Programme (2010). National Survey Report.
GMC (2010). Treatment and Care Towards the End of Life: good practice in decision making.
Gringer A (2009). Life after cancer in adolescence and young adulthood: The experience of survivorship.
Lave, J. and Wenger, E. (1991). Situated learning: legitimate peripheral participation.
Frank, A.W. (1995). The Wounded Storyteller: Body, Illness and Ethics.
Hutchison K, Rogers W. (2012). Challenging the epistemological foundations of EBM: what kind of knowledge does clinical practice require?. Journal of Evaluation in Clinical Practice. ,0 , pp. 984-991.
Anderson, R. and Bury, M. (1988). Living with Chronic Illness: the experience of patients and their families.
Gringer A (2007). Young people living with cancer.
Charmaz, K. (1999). Health, Illness and Healing: Society, social context and self.
Epstein RM, Street RL Jr (2007). Patient-centred communication in cancer care: Promoting healing and reducing suffering.
Bury, M. (1997). Health and Illness in a Changing Society.
The final assessment of the module is a negotiated assignment that meets the learning outcomes but will also be of benefit to your workplace
Repeat type: Internal & External
Costs associated with this module
Students are responsible for meeting the cost of essential textbooks, and of producing such essays, assignments, laboratory reports and dissertations as are required to fulfil the academic requirements for each programme of study.
In addition to this, students registered for this module typically also have to pay for:
Printing and Photocopying Costs
Applicants who are not from the UK will be assisted in the navigation of honorary contracts, disclosure and barring service check, and (potentially) UK registration with professional bodies once acceptance on the programme has been confirmed prior to the commencement of the programme. All costs associated with this (e.g. photocopying, postage) will be supported by the student.
Travel Costs for placements
Students not currently in employment will be assisted in the arrangement of suitable work-based experiences e.g. negotiating visitor status in local hospices to develop an understanding of leadership in the charity and voluntary sector and their contribution to the development of national strategy. All costs associated with these experiences will be supported by the student (e.g. lunch and travel costs).
Please also ensure you read the section on additional costs in the University’s Fees, Charges and Expenses Regulations in the University Calendar available at www.calendar.soton.ac.uk.