Emil, Palliative Care

Emil (Palliative Care) Case allows students to work through a realistic patient visit and subsequent interactions with Emil, a 72 year old male with an 8 month history of non curable non small cell lung cancer. The main learning objectives are to explore some issues surrounding end of life care such as understanding appropriate Palliative Care Symptom Management, exploring the different components of a goals of care discussion for advance care planning with a Palliative Care patient and his/her family and increasing the comfort level for discussing what to expect as death nears with the patient and family. This case is broken into three main sections – Emil's initial visit, which includes the assessment of his symptoms and an initial diagnosis; the therapy that you choose thereafter; and a follow-up visit after one month. The learner is encouraged to investigate, explore, ask questions, and make decisions based on realistic clinical encounters with the patient. Very little background about the patient is provided at the start of the case. As the learner moves through the case, the medical facts of the case are revealed. The learner will be required to engage general principles of history taking, consider principles of reflective practice, see how their attitude towards the patient affects the outcome, and be challenged to bring new ideas and approaches to the care and treatment of a patient with depression. This case is part of a series being generated for the CFPC SharcFM series. This particular case deals with various Palliative Care issues in Family Medicine. Follow Emil's case as he goes through a series of struggles.

「埃米尔（姑息治疗，Palliative Care）病例」可供学员沉浸式体验真实的接诊流程及后续与患者的互动场景：病例主人公为72岁男性，罹患不可治愈的非小细胞肺癌（non-small cell lung cancer），病程已达8个月。本次病例的核心教学目标为探讨临终关怀相关议题：包括掌握规范化的姑息治疗（Palliative Care）症状管理策略、明晰与姑息治疗患者及其家属开展预立医疗照护计划（advance care planning）时，照护目标讨论的各项构成要素，以及提升与患者及家属沟通临终阶段预期情况时的沟通熟练度。本病例分为三大核心模块：其一为埃米尔的初诊环节，涵盖症状评估与初步诊断；其二为后续治疗方案的选择环节；其三为为期1个月后的复诊环节。本病例鼓励学员基于与患者的真实临床交互场景开展调研、探索、提问并做出临床决策。病例初始阶段仅提供极少的患者背景信息，随着学员逐步推进病例学习，病例中的医学事实将逐步披露。学员需运用病史采集的通用原则，结合反思性实践的核心准则，体会自身对患者的态度如何影响诊疗结局，并需尝试运用全新的思路与方法，为合并抑郁状态的患者提供照护与治疗。本病例为CFPC SharcFM系列产出的病例之一，聚焦家庭医学领域中的各类姑息治疗议题。请跟随埃米尔的病例，见证他经历的一系列诊疗困境与心路历程。