October 2002

Grant Results

SUMMARY

Between 1998 and 2000, the U.S. Department of Veterans Affairs (VA) in Washington, worked to improve end-of-life and palliative care training in internal medicine residency training programs affiliated with the VA.

Key Results

  • Thirty educators at VA-affiliated internal medicine residency programs across the United States were selected to develop training opportunities for residents in end-of-life and palliative care. To encourage collaboration among the Faculty Leaders and like-minded colleagues, the project:
    • Convened three Faculty Leaders meetings and an interim planning meeting in conjunction with a VA national conference on pain management and end-of-life care to develop benchmark curricula and strategies.
    • Developed a private online discussion group in which Faculty Leaders conferred about issues related to end-of-life care and curricula development.
    • Launched a Web site targeted at educators who teach palliative medicine in academic and clinical settings (the Web site is no longer active).
  • Faculty Leaders reported measurable increases in satisfaction with their knowledge, skills and attitudes associated with excellent end-of-life and palliative care.

Key Findings
A survey of project sites measured educational and curricular changes. The survey found the following:

  • Some 29 of the 30 project sites developed curricula and strategies for implementation.
  • The number of sites with a formal curriculum devoted to end-of-life and palliative care increased from 3 to 19.
  • Some 10 additional sites developed and implemented informal curricula into their internal medicine residency training programs.
  • Project sites reported increases ranging from 30 to 54 percent in the number of clinical settings where residents are trained (i.e., inpatient acute care, inpatient and community hospice, nursing homes, geriatrics rotations) that are devoted to end-of-life and palliative care training.

Funding
The Robert Wood Johnson Foundation (RWJF) provided $943,180 in grant support for the effort.

 See Grant Detail & Contact Information
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THE PROJECT

The Department of Veterans Affairs (VA) worked to:

  1. Develop curricula to train internal medicine residents in the care of the dying patient.
  2. Integrate such curricula into 30 internal medicine residency training programs affiliated with the VA.
  3. Add to the cadre of internal medicine faculty leaders in the field of physician training for end-of-life and palliative care.
  4. Expand the curricula to all VA-affiliated internal medicine residency programs.

The Robert Wood Johnson Foundation (RWJF) provided grant support for the effort. Through its system of hospitals and its affiliations with U.S. medical schools and associated health education programs, the Veterans Health Administration provides training to about one-third of the nation's physicians.

A Steering Committee of 13 experts in end-of-life care and curriculum development advised the project staff, served as mentors for the Faculty Leaders and assisted in finding materials and other resources to develop curricula content (see Appendix 1). The project also included a number of collaborating partners — including hospice-related organizations, projects involved in educating physicians about end-of-life care and advocacy groups — to advance project goals, increase resources available to the Faculty Leaders and publicize project achievements. The VA provided in-kind support.

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RESULTS

  • Thirty educators at VA-affiliated internal medicine residency programs across the United States were selected to develop training opportunities for residents in end-of-life and palliative care. After being chosen through a competitive review process, these Faculty Leaders received partial salary support for two years to participate in the project (see Appendix 2 for a list of Faculty Leaders). To encourage collaboration among the Faculty Leaders and like-minded colleagues, the project:
    • Convened three Faculty Leaders meetings and an interim planning meeting in conjunction with a VA national conference on pain management and end-of-life care to develop benchmark curricula and strategies. Expertise gained through the project was extended to non-VA leaders interested in end-of-life care at the National Faculty Leaders Meeting, held in Atlanta, Ga. on June 26-27, 2000. At the meeting, 50 non-VA health care professionals joined 70 VA-affiliated staff to identify the leadership skills and resources necessary to create palliative training and care initiatives nationwide.
    • Developed a private online discussion group in which Faculty Leaders conferred about issues related to end-of-life care and curricula development. The discussion group was hosted at no charge by Growth House, a nonprofit organization that offers a comprehensive Web site of resources related to hospice and end-of-life care.
    • Launched a Web site (no longer active) targeted at educators who teach palliative medicine in academic and clinical settings. The site offers a selection of teaching and evaluation tools developed by individual programs and links to other members of the online community for palliative and hospice care. Project participants and others submitted model curricula and educational materials to be posted and included in the library database.
  • Faculty Leaders reported measurable increases in satisfaction with their knowledge, skills and attitudes associated with excellent end-of-life and palliative care. Among the indicators of increased involvement with these issues, 12 of the 30 Faculty Leaders reported attending the American Medical Association's Education for Physicians on End-of-Life Care (EPEC) training. (EPEC is an initiative designed to educate physicians in end-of-life care that has been supported by RWJF through May 2003 through ID#s 030204, 036767, 039301 and 040507; Sutton Social Marketing assessed it, ID# 039847). Some 12 Faculty Leaders also gave presentations on palliative care at national conferences and two were named Project on Death in America Faculty Scholars. (The Project on Death in America, funded by the Soros Foundation, supports outstanding clinical faculty who are making a commitment to improving end-of-life care.)

Findings

A survey of project sites measured educational and curricular changes. This was accomplished by comparing baseline data collected prior to the beginning of the project with the results of a survey sent to the 30 sites one year into the project. The survey found the following:

  • Some 29 of the 30 project sites developed curricula and strategies for implementation. With support from their facility and residency program leaders, Faculty Leaders carved out niches for training in end-of-life care, including such teaching venues as morning reports, noon conferences, grand and bedside rounds, interactive small group conferences, ethics committees and autopsies.
  • The number of sites with a formal curriculum devoted to end-of-life and palliative care increased from 3 to 19.
  • Some 10 additional sites developed and implemented informal curricula into their internal medicine residency training programs.
  • Project sites reported increases ranging from 30 to 54 percent in the number of clinical settings where residents are trained (i.e., inpatient acute care, inpatient and community hospice, nursing homes, geriatrics rotations) that are devoted to end-of-life and palliative care training.

Communications

VA staff and the Faculty Leaders made numerous presentations at VA-sponsored national meetings and elsewhere about their efforts to integrate end-of-life curricula into their education programs. Project staff compiled and distributed VA Faculty Leaders Project for Improved Care at the End-of-Life: The Compendium of Abstracts and Curriculum, summarizing the curricula and strategies developed by the Faculty Leaders, to VA medical centers, affiliated medical schools, VA staff and members of the U.S. Congress. This compendium was also posted on the Faculty Leaders project Web site (no longer active). An overview of the project was published in the Journal of Palliative Medicine. (See the Bibliography for further details.)

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AFTER THE GRANT

After the grant period, the Faculty Leaders' online discussion group was opened to all VA and affiliated staff involved in pain management and end-of-life care. Currently, 250 VA health care professionals participate in this group. The project Web site has been transferred to the End-of-Life and Palliative Care Web page, maintained by the VA's Office of Academic Affiliations (OAA). The URL is the same.

As a result of the Faculty Leaders project, in 2000, the VA launched the Training and Program Assessment for Palliative Care (TAPC) Project aimed at advancing the development of palliative care programs within the VA system. As part of that initiative, the VA created an interdisciplinary fellowship to provide palliative care training. The project will support four fellows in each of six sites, including a hub that will create the curriculum for all the sites.

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GRANT DETAILS & CONTACT INFORMATION

Project

Veterans Affairs Faculty Fellows Program in End-of-Life Care

Grantee

U.S. Department of Veterans Affairs (Washington,  DC)

  • Amount: $ 943,180
    Dates: June 1998 to June 2000
    ID#:  034588

Contact

Thomas L. Garthwaite, M.D.
(202) 273-8379

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APPENDICES


Appendix 1

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

VA Faculty Leaders Project Steering Committee

Susan Block, M.D.
Chief, Psychosocial Oncology Program
Dana Farber Cancer Institute
Boston, Mass.

Chris Cassel, M.D.
Professor and Chairman
Department of Geriatric & Adult Development
Mt. Sinai Medical Center
New York, N.Y.

Meghan Gerety, M.D.
ACOS and Service Line Manager
Geriatrics and Extended Care (OOE)
VA Medical Center
San Antonio, Texas

James Hallenbeck, M.D.
Medical Director
Palo Alto Healthcare System Hospice
Palo Alto, Calif.

Jeff Halter, M.D.
Professor, Internal Medicine
Director, University of Michigan Geriatric Center
Ann Arbor, Mich.

Tom Hornick, M.D.
Residency Program Director
Department of Medicine
VA Medical Center
Cleveland, Ohio

Lisa Kaplowitz, M.D.
Director
Virginia Commonwealth University
HIV/AIDS Center
Richmond, Va.

David Leach, M.D.
Executive Director
Accrediation Council for Graduate Medical Education (ACGME)
Chicago, Ill.

Tim Quill, M.D.
Associate Chief of Medicine
Department of Medicine
Genesee Hospital
Rochester, N.Y.

Kelley Skeff, M.D.
Director, Medicine Residency Training Program
Department of Medicine
Stanford University Medical Center
Stanford, Calif.

James Tulsky, M.D.
Director, Program on the Medical Encounter and Palliative Care
VA Medical Center
Durham, N.C.

David Weissman, M.D.
Director, Palliative Medicine Program
Division of Hematology and Oncology
Medical College of Wisconsin
Milwaukee, Wis.

Michael Whitcomb, M.D.
Senior Vice President
Division of Medical Education
Association of American Medical Colleges
Washington, D.C.


Appendix 2

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

VA Faculty Leaders

Saraswathy Battar, M.D.*
(Year 1)
Hospice and Palliative Medicine Coordinator
VA Medical Center
Albuquerque, N.M.
(Year 2 & 3)
VA Central Iowa Health Care System
Knoxville, Iowa

Kenneth Berkowitz, M.D.
Medical Director, Home Based Primary Care
VA New York Harbor Health Care System
New York, N.Y.

Marie Bernard, M.D.
Professor and Chairman
Department of Geriatric Medicine
VA Medical Center
Oklahoma City, Okla.

Kwi Bulow, M.D.
Staff Physician
San Diego VA Healthcare System
La Jolla, Calif.

Pat Caralis, M.D., J.D.
Chief, General Medicine
VA Medical Center Medical Service
Miami, Fla.

David Casarett, M.D.
(Year 2 & 3)
Instructor, Division of Geriatrics
VA Medical Center
Geriatrics and Extended Care, Nursing Home Unit
Philadelphia, Pa.

Stephen Chavin, M.D.**
(Year 1)
University of Pennsylvania School of Medicine
Philadelphia, Pa.

James Cleary, M.D.
Staff Physician
Univerity of Wisconsin Comprehensive Cancer Center
Madison, Wis.

George Crawford, M.D.
Associate Chair for Education
Department of Medicine
University of Texas Health Science Center at San Antonio
San Antonio, Texas

Teresa Dolinar, M.D.
Assistant Professor of Medicine
Louis Stokes Cleveland VA Medical Center
Cleveland, Ohio

LuAnn Eidsness, M.D.
Associate Professor of Internal Medicine
Royal C. Johnson Veterans Memorial Hospital
Sioux Falls, S.D.

Jon Fuller, M.D.
Director of Home Based Primary Care
VA Medical Center
San Francisco, Calif.

Steven Hardin, M.D.
Staff Physician
Jerry L. Pettis Memorial Veterans Medical Center
General Internal Medicine
Loma Linda, Calif.

Michelle Hankins, M.D.
Staff Physician
Department of Hematology/Oncology
VA Boston Healthcare System
Out Patient Clinics
Boston, Mass.

Carol Joseph, M.D.
ACOS Geriatrics and Extended Care
VA Medical & Regional Office Center
Honolulu, Hawaii

Anand Karnad, M.D.
Chief, Hematology-Oncology Service
James H. Quillen VA Medical Center
Johnson City, Tenn.

Geetika Kumar, M.D.
Director of Hospice and Palliative Care
VA Medical Center
Dayton, Ohio

June Leland, M.D.
Director of Community and Hospice Medicine
James A. Haley VA Hospital
Tampa, Fla.

David Lowenthal, M.D., Ph.D.
Geriatric Fellowship Director; Director, GRECC
VA North Florida/South Georgia Veterans Health Care System
Gainesville, Fla.

Dean Miner, M.D.
Program Director
Combined Residency Training Program in
Internal Medicine and Pediatrics
VA Medical Center
Birmingham, Ala.

Ellen Olson, M.D.
Chief, Geriatrics Service
VA Medical Center
Bronx, N.Y.

Molly Osborne, M.D., Ph.D.
Associate Professor of Pulmonary and Critical Care
VA Medical Center
Portland, Ore.

Leslye Pennypacker, M.D.
Chief of Geriatrics
Ralph H. Johnson Medical Center
Charleston, S.C.

Thomas Prendergast, M.D.
Chief, Pulmonary Section
VA Medical & Regional Office Center
White River Junction, N.H.

Beth Popp, M.D.***
Clinical Director, Section of Palliative Medicine
St. Vincents Hospital and Medical Center
Department of Medicine
New York, N.Y.

Kenneth Rosenfeld, M.D.
Assistant Professor of Medicine
VA Greater Los Angeles Health Care System
Los Angeles, Calif.

Michelle Schultz, M.D.
Staff Physician
John J. Cochran Memorial Veterans Hospital
Hematology/Oncology Department
St. Louis, Mo.

Scott Shreve, D.O.
ACOS for Extended Care
VA Medical Center
Extended Care (N500)
Lebanon, Pa.

Emese Somogyi-Zalud, M.D.
Staff Physician
Geriatrics Section
VA Medical Center
Washington, D.C.

Monica Spaulding, M.D.
Chief, Oncology Section
VA Western New York Health Care System
Buffalo, N.Y.

Basil Varkey, M.D.
Professor of Medicine
Clement J. Zablocki Medical Center
Pulmonary and Critical Care
Milwaukee, Wis.

* Saraswathy Battar changed institutions but retained Faculty Leader position.
** Stephen Chavin left the VA after Year 1 of the project; he was replaced by David Casarett.
*** Beth Popp was stationed at Brooklyn during the Faculty Leaders Project and recently has accepted a position at St. Vincents Hospital.

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Books and Reports

VA Faculty Leaders Project for Improved Care at the End of Life: Compendium of Abstracts and Curricula. Washington, D.C.: Office of Academic Affiliations, Department of Veterans Affairs, June 2000.

Articles

Stevens DP, Jones DH, Salerno JA and Ryan BJ. "A Strategy for Improvement in Care at the End of Life: The VA Faculty Leaders Project." Journal of Palliative Medicine, 2(November 1): 5–7, 1999.

Karnad AB. "Humanistic Qualities in End-of-Life Care: Lessons from The Diving Bell and the Butterfly. A Memoir of Life in Death — Required Reading in an End-of-Life Care Curriculum for Internal Medicine Residents." Journal of Palliative Medicine, 2(Winter): 411–416, 1999.

Survey Instruments

"VA Faculty Leaders Project: Retrospective and Current Measures of Project Outcomes," Department of Veterans Affairs, fielded September 1999 to the 30 programs in the project.

Sponsored Conferences

1st National Faculty Leaders Meeting, October 13–14, 1998, Warrenton, Va. Attended by the 30 Faculty Leaders, 10 of the 12 Steering Committee members and five VA staff. Five presentations.

Presentations

  • David Stevens, Veterans Health Administration (Washington, D.C.), "Introduction to the VA Faculty Leaders Project."
  • Judith Salerno and Timothy Quill, Genesee Hospital Department of Medicine (Rochester, N.Y.), "The End of Life Movement: Inside and Outside the VA."
  • Bonnie Ryan, Veterans Health Administration (Washington, D.C.); Susan Block, Harvard Pilgrim Health Care (Boston, Mass.); James Hallenbeck, Palo Alto VA Healthcare System Hospice (Palo Alto, Calif.); and James Tulsky, Durham VA Medical Center (Durham, N.C.), "Curriculum Resources in End of Life Care: Attitudes, Knowledge and Skills."
  • David Stevens, Veterans Health Administration (Washington, D.C.), "Next Steps."

2nd National Faculty Leaders Meeting, June 21–23,1999, Snowbird, Utah. Attended by 28 of 30 Faculty Leaders, eight of 13 Steering Committee members and three of four Executive Committee members. Four presentations, five panels and five workshops.

Presentations

  • James Tulsky, Durham VA Medical Center (Durham, N.C.); Susan Block, Dana Farber Cancer Institute (Boston, Mass.); Tim Quill, Genesee Hospital Department of Medicine (Rochester, N.Y.); and David Weissman, Medical College of Wisconsin (Milwaukee, Wis.), "Teaching Communications with Patients at the End of Life."
  • Kenneth Kizer, Veterans Health Administration (Washington, D.C.), "After Dinner Comments."
  • Terry Krosan, Academic Information Management Center (St. Louis, Mo.) and Diane Jones, VA Faculty Leaders Project (Washington, D.C.), "High Tech Communication: Continuing the Conversation."
  • David Stevens, Veterans Health Administration (Washington, D.C.), "Pulling It Together I & II."

Panels

  • James Hallenbeck, VA Palo Alto Healthcare System (Palo Alto, Calif.) and David Weissman, Medical College of Wisconsin (Milwaukee, Wis.), "Pulling It Together I: Implementing Benchmark Curricula."
  • Tom Prendergast, VA Medical & Regional Office Center (White River Junction, Vt.) and David Leach, ACGME (Chicago, IL), "Pulling It Together II: Next Steps."
  • Thomas Hornick, Cleveland VA Medical Center (Cleveland, Ohio), moderator, "Five Minutes of Excellence." Nine Faculty Leaders presented successes in their programs.
  • Lisa Kaplowitz, Virginia Commonwealth University (Richmond, Va.), moderator, "Five Minutes of Excellence." Nine Faculty Leaders presented successes in their programs.
  • Meghan Gerety, San Antonio VA Medical Center (San Antonio, Texas) moderator, "Five Minutes of Excellence." Eight Faculty Leaders presented successes in their programs.

VA National Leadership Conference on Pain Management and End of Life Care, November 3–5, 1999. Attended by more than 300 VA staff. Eight Faculty Leaders participated in presentations, 14 attended conference and an additional seven attended a special Faculty Leaders meeting by conference call. 12 presentations and 33 workshops.

Presentations

  • Judith A. Salerno, Veterans Health Administration (Washington, D.C.) "Introduction and Welcome."
  • Kenneth Kizer, Veterans Health Administration (Washington, D.C.), "Keynote Address."
  • Preston Darby, "The Pain of Reality."
  • John Loeser and Carla Alexander, "National Perspectives on Pain Management and End-of-Life Care."
  • Frances Murphy, "VA Initiatives Update."
  • Dennis Turk, "Assessing and Differentiating Pain."
  • Ron Wyden, US Senate (Washington, D.C.), "Conquering Pain Act of 1999."
  • Kathy Foley, "Oncology Pain Management."
  • David Weissman, Medical College of Wisconsin (Milwaukee, Wis.), "Physician End-of-Life Education."
  • Jane Tollett and Bonnie Ryan, moderators, "Work Group Reports."
  • Jane Tollett and Bonnie Ryan, facilitators, "Next Steps — Action Plan."
  • Thomas Holohan, "Concluding Remarks."

3rd National Faculty Leaders Meeting, June 26–27, 2000, Atlanta, Ga. Attended by 28 of 30 Faculty Leaders, four of 13 Steering Committee members, and 76 additional VA and non-VA health care professionals. Six presentations, three work groups and one post-meeting workshop.

Presentations

  • Rosemary Gibson, The Robert Wood Johnson Foundation (Princeton, N.J.), "Opening Remarks."
  • Christine Cassel, Mt. Sinai Medical Center (New York, N.Y.), "Keynote Address: The Ideal State of Palliative Care."
  • David Stevens, Association of American Medical Colleges (Washington, D.C.), "Introduction to Workgroups: Building on What We've Learned."
  • Thomas Garthwaite, Department of Veterans Affairs (Washington, D.C.), "Policy Implications in End-of-Life Care."
  • Eric Warm, University of Cincinnati College of Medicine (Cincinnati, Ohio), "Fast Facts and Concepts."
  • James Hallenbeck, Palo Alto Healthcare System Hospice (Palo Alto, Calif.), "Work Group Reports."

Work Groups

  • James Hallenbeck, Palo Alto Healthcare System Hospice (Palo Alto, Calif.) and Molly Osborne, VA Medical Center (Portland, Ore.), facilitators, "Education and Training."
  • James Tulsky, VA Medical Center (Durham, N.C.) and Anand Karnad, James Quillen VA Medical Center (Johnson City, Tenn.), facilitators, "Interdisciplinary/Interprofessional Care."
  • David Stevens, Association of American Medical Colleges (Washington, D.C.) and Beth Popp, St. Vincent's Hospital and Medical Center (New York, N.Y.), "Leveraging Institutional Change."

Presentations and Testimony

June Leland, "The Television Comes Home," at joint National Hospice Organization/American Academy of Hospice and Palliative Medicine/Hospice and Palliative Nurses Association meeting, February 19–20, 2000, Nashville, Tenn.

Ellen Olson, "What Constitutes a Comfortable Death," at joint National Hospice Organization/American Academy of Hospice and Palliative Medicine /Hospice and Palliative Nurses Association meeting, February 19–20, 2000, Nashville, Tenn.

Sara Battar, "Implementation of EPEC Curriculum in Residency Training Programs," at American Medical Directors Association Annual Symposium, March 16–19, 2000, San Francisco, Calif.

June Leland, "Completing the Death Certificate," at American Medical Directors Association Annual Symposium, March 16–19, 2000, San Francisco, Calif.

Steven B. Hardin, "Difficult End of Life Treatment Decisions: Do Other Factors Trump Advance Directives?" at Society of General Internal Medicine 23rd Annual Meeting," May 4–6, 2000, Boston, Mass.

Emese Somogyi-Zalud, "The Use of Life Sustaining Treatments in Hospitalized Persons 80 Years and Older" (published as "Elderly Persons' Last Six Months of Life: from the Hospitalized Elderly Longitudinal Project," in Journal of the American Geriatrics Society, 48:S131–S139, 2000) at Society of General Internal Medicine 23rd Annual Meeting," May 4–6, 2000, Boston, Mass.

David Casarett, "How to Learn to Love Your Institutional Review Board and Other Tips on the Responsible Conduct of Research," at American Geriatrics Society Annual Meeting, May 17–21, 2000, Nashville, Tenn.

Anand Karnad, James H. Quillen VA Medical Center (Mountain Home, Tenn.), "Using Caregivers to Teach Internal Medicine Residents Attitude-Development in End-of-Life Communication Skills," at American Geriatrics Society Annual Meeting, May 17–21, 2000, Nashville, Tenn.

Panagiota Caralis, VA Medical Center (Miami, Fla.), "The Impact on End-of-Life Care of Strategies for Integrating Palliative Medicine into the Academic Environment," at American Geriatrics Society Annual Meeting, May 17–21, 2000, Nashville, Tenn.

Jon Fuller, VA Medical Center (San Francisco, Calif.), "Home Care Reduces Hospital Utilization," at American Geriatrics Society Annual Meeting," May 17–21, 2000, Nashville, Tenn.

Sara Battar, VA Central Iowa Health Care System (Knoxville, IA), "Where East Does Not Meet West: End of Life Care Provision from Cross Cultural Point of View," at American Academy of Hospice and Palliative Care 12th Annual Assembly," June 27–30, 2000, Atlanta, Ga.

Panagiota Caralis, VA Medical Center (Miami, Fla.), "Integrating Palliative Medicine Into Medical Housestaff Training Program," at American Academy of Hospice and Palliative Care 12th Annual Assembly," June 27–30, 2000, Atlanta, Ga.

June Leland, James A. Haley VA Medical Center (Tampa, Fla.), "Telemedicine in the Management of End Stage Diseases," at American Academy of Hospice and Palliative Care 12th Annual Assembly," June 27–30, 2000, Atlanta, Ga.

Basil Varkey, Clement J. Zablocki Medical Center (Milwaukee, Wis.), "Impact of The VA Faculty Leaders Project on Palliative Care Education of Resident Physicians," at American Academy of Hospice and Palliative Care 12th Annual Assembly," June 27–30, 2000, Atlanta, Ga.

David Casarett, VA Medical Center (Philadelphia, Pa.), "How to Learn to Love Your Institutional Review Board and Other Tips on the Responsible Conduct of Research," at American Academy of Hospice and Palliative Care 12th Annual Assembly," June 27–30, 2000, Atlanta, Ga.

Scott Shreve, VA Medical Center (Lebanon, Pa.), "Inpatient VA Hospice Care: Clinically Needed, Promoted by VERA," at American Academy of Hospice and Palliative Care 12th Annual Assembly," June 27–30, 2000 Atlanta, Ga.

World Wide Web Sites

www.va.gov/oaa/flp (no longer active). The VA Faculty Leaders Web site offered information about the work of the Faculty Leaders and a selection of teaching and evaluation tools developed by individual programs and links to other members of the online community for palliative and hospice care. This site offered an expanded database to house additional educational materials and products related to palliative care training and education.

Press Kits and News Releases

"VA End-of-Life Project Selects Faculty Leaders," along with a complete list of the 30 Faculty Leaders and Steering Committee members, mailed on October 30, 1998, to 120 opinion leaders in VA Medical Centers and their medical school affiliates.

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Report prepared by: Kelsey Menehan
Reviewed by: Karyn Feiden
Reviewed by: Janet Heroux
Program Officer: Rosemary Gibson