The Use of E-Learning, Narrative, and Personal Reflection in a Medical School Ethics and Palliative Care Course (FR482E)

•Describe the opportunities and challenges inherent in teaching Palliative Care over e-learning platforms.•Utilize narrative to engage learners as well as engender empathy and emotional awareness.•Identify methods for encouraging personal reflection and meaning building in medicine. The growth of E-Learning and Adult Learning Theory have presented new challenges and opportunities for medical education. This course combines the accessibility and adaptability of online tools with the interactive and collaborative nature of in-person participation. It leverages the studied benefits of narrative, group discussion, reflection and asynchronous learning to introduce learners to Palliative Care and Medical Ethics. The target audience is anyone involved in medical education seeking new ways to effectively use online learning in Hospice and Palliative Care. The targets of the course are learners at any level of medical training. It could also be utilized by other disciplines by adapting the narratives. The course is online and discussion based. Each week students are presented with a line of the Hippocratic Oath, a short unit discussing the relevant ethical and palliative principles, a section of the course narrative representing both patient and provider perspectives, suggested readings, and a discussion question. Students then post both an original response as well as participate in message-board based discussion with classmates and instructors. After several units, participants post a personal reflection as a self-addressed letter stating what they intend to take away from their collaboration. The course is in its third year, and each year approximately 125 students take part. Outcomes are measured both by observation of students' participation as well as post-course surveys. Comments have been positive with suggestions including introduction of some in-person video modules with discussion. This innovation integrates e-learning, narrative and discussion to improve palliative and ethical competence, increase self-awareness and empathy, and grow interest in Hospice and Palliative Care. Comments have identified the course's narrative, discussion, and reflection as effective tools for engaging with palliative principles. In the future, in-person video modules and group reflection will be added.