February 2007

Grant Results

National Program

Targeted End-of-Life Projects Initiative

SUMMARY

The "Wit" Film Project is a medical training program using the Emmy Award-winning HBO film adaptation of the stage play "Wit" to advance education on end-of-life care. "Wit" depicts a dying patient's struggles and end-of-life treatment problems.

Beginning in 2002, project staff at the University of California, Los Angeles, School of Medicine disseminated the program free-of-charge via a Web site to medical schools in the United States and Canada.

The project was part of the Robert Wood Johnson Foundation's (RWJF) national program Targeted End-of-Life Projects Initiative.

Key Results
By July 2004:

  • Sixty-two schools and training programs in the United States and Canada had used the program in their end-of-life training.
  • The project had distributed some 400 copies of the film "Wit".

Funding
RWJF provided $137,732 for this solicited project.

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THE PROBLEM

The 1989–1994 Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT) revealed significant end-of-life care treatment problems, including aggressive ICU-based care and pain in patients' final days. The study was funded by RWJF and published in the November 22, 1995, issue of the Journal of the American Medical Association. The 1997 RWJF Anthology, To Improve Health and Health Care, included a chapter on SUPPORT.

A study published in the February 3, 2000, issue of the New England Journal of Medicine found that children dying of cancer experienced fear and significant suffering from one or more symptoms.

Staff at UCLA School of Medicine launched the "Wit" Educational Initiative (WEI) in February 2000 as a tool for teaching medical students end-of-life care.

Originally, the staff worked with local theatre companies to bring productions of the play "Wit" into U.S. and Canadian medical schools and training facilities. Many medical training programs, however, were unable to show the play to students, due to an absence of local theater companies. Therefore, UCLA School of Medicine switched to using the HBO film.

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RWJF STRATEGY

RWJF funded this project under its Targeted End-of-Life Projects Initiative. This authorization supported solicited and unsolicited projects that advance RWJF's strategic objective to improve care at the end of life. RWJF has pursued three strategies in its effort to improve care at the end of life:

  1. To improve the knowledge and capacity of health care professionals and others to care for the dying.
  2. To improve the institutional environment in health care institutions and in public policies and regulatory apparatus to enable better care of the dying.
  3. To engage the public and professionals in efforts to improve end-of-life care.

This grant fell under the first strategy.

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THE PROJECT

Staff at UCLA launched the RWJF-funded project, renamed the "Wit" Film Project (WFP), in December 2001 to disseminate in U.S. and Canadian medical schools a training program centered on the 2001 HBO film adaptation of "Wit".

UCLA staff developed educational materials to accompany the film showing, including pre- and post-performance lectures, a small group discussion guide, a step-by-step checklist for planning the program on-site, and an evaluation form.

Educators at medical schools and other programs concerned with end-of-life care can download the materials at the project Web site. HBO provides copies of the film "Wit" free of charge to participating programs.

The project marketed the program to medical schools through e-mail, mail and presentations at conferences.

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RESULTS

Project staff reported these results as of July 31, 2004:

  • Some 62 schools and training programs in the U.S. and Canada had used the "Wit" end-of-life program as part of medical school curricula or for continuing education in hospice and hospitals.
  • Project staff had sent out 400 copies of the "Wit" film to educational programs.
  • Curriculum materials had reached medical schools in Germany, Australia, Israel and England.

Findings

The project received some 1,600 completed evaluations from 20 sites. Among the findings:

  • More than 56 percent of respondents found the "Wit" program more useful than bedside rounds for learning about the care of dying patients.

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GRANT DETAILS & CONTACT INFORMATION

Project

Wit Film Project to Teach Medical Students About End-of-Life Care

Grantee

University of California, Los Angeles, Center for Health Sciences (Los Angeles,  CA)

  • Amount: $ 137,732
    Dates: December 2001 to July 2004
    ID#:  043719

Contact

Kenneth Rosenfeld, M.D.
(310) 478-3711
Kenneth.Rosenfeld@med.va.gov

Web Site

http://www.growthhouse.org/witfilmproject

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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.)

World Wide Web Sites

www.growthhouse.org/witfilmproject. The project site includes information about the film, the program, download guides for implementing the curriculum and links to other end-of-life resources. The Web site is part of the Growth House portal, which is a gateway to resources for life-threatening illness and end-of-life care. San Francisco: Growth House, 2001.

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Report prepared by: Cheryl A. Sweet
Reviewed by: Kelsey Menehan
Reviewed by: Molly McKaughan
Program Officer: Paul Tarini

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