ABFM Palliative Care study plan

Define the palliative care approach and differentiate it from hospice care and from disease-directed therapy, then list three triggers that should prompt a palliative referral in primary care

Compute and interpret the Palliative Performance Scale, ECOG performance status, and Karnofsky score on six written vignettes and state the survival range each implies

Apply the surprise question and at least three validated prognostic tools (e.g., PaP score concept, ePrognosis-style indices, NYHA or COPD or dementia-specific trajectories) to four case vignettes and write the estimated prognosis in months

Explain illness trajectories for cancer, organ failure, frailty, and dementia, and identify which trajectory makes hospice eligibility hardest to predict

Perform a structured primary pain assessment on two standardized patients or colleagues, documenting onset, quality, radiation, severity, timing, aggravating and relieving factors, prior treatments, and functional impact

Convert equianalgesic doses among morphine, oxycodone, hydromorphone, fentanyl transdermal, and methadone across at least 15 written problems with 90% or better accuracy, including incomplete cross-tolerance dose reduction

Select and justify an opioid titration and breakthrough-dose plan for mild, moderate, and severe pain in opioid-naive and opioid-tolerant patients

Differentiate nociceptive, neuropathic, and mixed pain mechanisms and match each to first-line adjuvant agents with starting doses and titration intervals

Recognize and manage opioid adverse effects (constipation, nausea, sedation, pruritus, myoclonus, opioid-induced neurotoxicity) and state when to rotate opioids

Screen for substance use risk using a validated tool and describe a monitoring plan for a patient with active or prior misuse who requires opioids

Construct a stepwise pharmacologic and non-pharmacologic plan for dyspnea in advanced disease, including opioid dosing for breathlessness and when to use oxygen

Build a nausea and vomiting treatment ladder organized by presumed mechanism (gastric stasis, vestibular, chemoreceptor trigger zone, cortical) and match each to a drug class

Design a bowel regimen that prevents opioid-induced constipation and adjust it for a patient with a bowel obstruction

Identify and manage delirium using the Confusion Assessment Method, stating reversible causes to screen for and first-line antipsychotic dosing plus non-drug measures

Plan management of at least six additional symptoms (fatigue, anorexia and cachexia, xerostomia, excess secretions, insomnia, pruritus) with one first-line and one alternative intervention each

Deliver the SPIKES six-step protocol for breaking bad news in two recorded role-plays and self-score against a written checklist

Conduct a goals-of-care conversation that moves from values to a specific recommendation, and document the outcome in a written note

Practice ask-tell-ask, reflective listening, and at least three ways to respond to strong emotion ('NURSE' statements) in a simulated encounter

Screen for spiritual distress and depression and anxiety using FICA-style questions and a validated tool such as PHQ-2 or GAD-7, and state when to refer

Describe how culture, health literacy, family structure, and religious practice shape decision making, and list three accommodations to build into a care plan

Distinguish withholding and withdrawing treatment, voluntary stopping of eating and drinking, palliative sedation, and physician-assisted death as defined in the United States, and state the ethical principle justifying each

Determine hospice eligibility for at least five diagnoses (cancer, heart failure, COPD, dementia, ESRD or liver disease) using published decline and functional criteria

Write orders for the final 48 hours covering pain, dyspnea, secretions, agitation, and discontinuation of non-beneficial medications and monitoring

Explain the process of death pronouncement, completing the death certificate, and after-death family care

Complete a capacity assessment and describe surrogate decision-making hierarchy and the limits of advance directives in your jurisdiction

Map the roles and communication handoffs among physician, nurse, social worker, chaplain, pharmacist, aide, and therapist in a home hospice or inpatient palliative team

Explain the Medicare hospice benefit structure, including election and revocation, levels of care, per-diem payment, and the live discharge and recertification requirements

Describe documentation and coding essentials for palliative encounters, including time-based billing and advance care planning codes

Identify at least four quality metrics used in palliative and hospice programs and explain how a team would respond to a low score

Resolve two written team-conflict scenarios using a structured approach, and state when to escalate to ethics consultation

Compare pediatric and adult palliative care across symptom assessment, opioid dosing by weight, and family-centered decision making, and calculate weight-based opioid and adjuvant doses for two cases

Describe perinatal palliative care components, including prenatal diagnosis counseling, birth planning, and comfort care for a neonate with a life-limiting condition

Explain developmental understanding of death by age group and adapt an explanation of serious illness for a 4-year-old, an 8-year-old, and a 15-year-old

Identify sibling, school, and family support needs and name the team members who address each

State the legal and ethical framework for pediatric assent and parental consent, including situations of disagreement

Differentiate normal, anticipatory, prolonged, and disenfranchised grief and screen for complicated bereavement risk using a validated tool

Design a bereavement follow-up plan that includes a timeline of contacts, risk stratification, and referral triggers for the caregiver and family

Assess caregiver burden and burnout and list three concrete supports, including respite care and financial and insurance resources

Rehearse one existential or legacy-oriented conversation and one conversation with a family after a death

Synthesize all ten domains into a personal 15-item high-yield review sheet of facts you most often miss