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Palliative care clinicians enhance the illness experiences of patients and their families through building therapeutic relationships. Many psychological concepts underlie a clinician's approach to a specific patient. Through high-yield tips, this article highlights ten selected psychological elements that palliative care clinicians often use to support patients. As we all (both clinicians and patients) bring our own histories and unique biographies to the work of palliative care, a more explicit focus on the psychological aspects of this work can enhance our own experience and efficacy as providers. With a thoughtful focus on the psychological aspects of how we engage with patients, palliative care clinicians can offer a more meaningful therapeutic encounter. [ABSTRACT FROM AUTHOR]

1. Participants will self-report an enhanced ability to describe preclinical medical and dental students' reactions to early observed encounters with seriously ill and dying patients. 2. Participants will self-report the ability to appraise and apply interprofessional approaches to supporting student wellness in the context of early clinical exposure. Preclinical medical and dental student responses to early observed clinical encounters with seriously ill and dying patients reveal opportunities for faculty to support student wellness. Interprofessional HPM clinician-educators utilize approaches involving validating, educating, and empowering learners following early experiences. Lessons learned from these approaches can inform faculty development around the lived student experience and strategies for proactively supporting student wellness. Previous work highlights the value of preclinical medical student exposure to the practice of hospice and palliative medicine (HPM) and indicates that students may experience strong or unanticipated emotion in early encounters with seriously ill or dying patients. To explore the nature of students' processing of early interactions with seriously ill patients and their families, as well as opportunities for HPM clinician-educators to support student wellness in the context of these experiences. In 2023, 167 first-year medical and dental students at a large urban medical school were assigned a written reflection following a half-day faculty-mentored HPM shadowing experience and debriefing session. An HPM clinician-educator (physician, nurse, social worker, or chaplain) provided a written response to each reflection. Qualitative analysis was utilized to identify themes arising from both student reflections and clinician-educator responses. 150/167 students (90%) submitted reflections; 150/150 reflections (100%) were provided written responses by an HPM clinician-educator. Three primary student content themes were revealed: 1) strong emotions related to witnessing difficult circumstances (e.g., uncontrolled symptoms; imminently dying patients; personally resonant situations), 2) acquisition of new HPM knowledge (e.g., palliative care is not reserved only for end of life), and 3) impact of the experience on anticipated future patient care (e.g., inspiration to build meaningful connections with patients). Primary faculty response themes included: 1) validation of emotion/strategies for self-care, 2) reinforcement of/expanded detail on HPM principles, and 3) sharing personal insights and opportunities for continued professional development. Students' written reflections suggest common themes in processing observations of clinical encounters with seriously ill and dying patients. HPM clinician-educators across professions shared an approach to supporting student wellness that involved validating, educating, and empowering. Lessons learned could inform faculty development around the lived student experience and opportunities to proactively support student wellness. Resilience / Well being / Interdisciplinary Teamwork / Professionalism [ABSTRACT FROM AUTHOR]

The Latinx population faced higher rates of infection and severe illness during the COVID-19 pandemic, resulting in an increased need for palliative care services. We describe the creation and impact of a formal palliative care initiative developed for seriously ill, Spanish-speaking patients during the COVID-19 pandemic at a tertiary care academic medical center. Patients were enrolled in the Spanish Palliative Care Initiative during a two-month period starting in April 2020. Selected patients were longitudinally followed by a rotating team of Spanish-speaking palliative care clinicians. Following the intervention, a retrospective chart review was conducted to evaluate the impact of the program. We enrolled 22 patients. The most frequent palliative care task completed during the initial visit was information giving (77%) and during follow-up visits were goals of care discussion (59%) and coping support (59%). Fifteen patients (68%) had a change in code status and 4 patients (18%) were discharged to hospice. The creation of a focused clinical program targeting a historically marginalized population offered opportunity for early palliative care intervention in clinical care for Spanish-speaking patients. This underscores the need for Spanish-language concordant palliative care to improve serious illness care, and end-of-life care, by providing continuity of care, spiritual care, and ICU team support. [ABSTRACT FROM AUTHOR]