Student helps develop palliative care tools

Madeleine Tickle’s scholarly intensive placement coordinator was a little concerned that she was neglecting her project and spending too much time getting clinical experience.

“I definitely was working on it,” says Madeleine. It’s just that she found being able to talk to the sort of patients her project involved so valuable.

Knowledge translation in palliative care

Madeleine was at Bendigo Health palliative care working on a knowledge translation project. The task was to use what had been learned in a research project to develop resources that could be used in clinical practice, modifying a British tool for managing breathlessness for Australian conditions. It was part of a bigger project being managed by her supervisor, palliative medicine specialist Dr Buddy Mudugamuwa, to improve how health practitioners manage breathlessness in their patients.

In the mornings, Madeleine attended ward rounds with the palliative care registrar from whom she learned a lot. “Not just in terms of the actual medicine, but how to approach a lot of those patients.” Once they had drafts of the new brochures, she went on home visits with a nurse. “She was very experienced in dealing with breathlessness and with patient education. So I was able to learn a lot from her that we then put into these tools.”

Patients themselves contributed to the project. Madeleine remembers one younger patient who had already been using some of those strategies. The team had been pacing their explanations with most patients only handing out one or two brochures at a time. “But with this particular patient, I was able to provide almost all of the brochures at once. We were able to work with him and figure out the best way to use these brochures to improve the strategies. I learned a lot from him.”

A lot of medicine is about communication

One of her most important learnings from the project was actually about patient communication. “A lot of medicine is about communication and you learn a lot from watching other people. But I had never just gone away by myself and read about how I could improve my own communication.”

Dr Mudugamuwa was particularly good at pointing her towards relevant reading. If she had a patient encounter that she felt could have gone better, but she wasn’t exactly sure how, he could point her to exactly what she needed to read. “It was a really great way to learn because, once I'd actually experienced it myself, I wanted to figure out how it is addressed in real life and it meant it became really relevant,” said Madeleine.

Better equipped to start work

She says she feels a lot better equipped when she starts working, now that she’s using evidence based communication strategies. “So much of what you're doing is about effective communication. Being able to do both the clinical and the scholarly side of things means you get to learn about it in a clinical sense, but also in an evidence based sense, which is a really interesting way to be learning about the two. Learning about research is important but it’s also important to develop skills in translating the findings of research so that it can be accessible and relevant to patients.”

A scholarly project in a clinical setting enables you to see directly how your work is going to be effective she says. “I'd be very interested in doing clinical research, where you can directly be working with patients, generating new knowledge and improving their care.”

Madeleine Tickle learned a lot about patient communication during her six weeks with Bendigo Health palliative care.