Reflections by an American on being a visiting Professor in Italy

Abstract

feeding tubes for elderly patients with advanced dementia. Our most extensive and vigorous conversations centered on how to help families and patients engage in establishing goals of care, and avoiding unnecessary suffering and burden for both. Hospice and palliative medicine was a topic we returned to in discussions of other core geriatrics topics; e.g., dementia, nursing home care, pressure sores. Multiple students contacted me outside of class and after the end of the course, interested in more detail on many of the topics we discussed. Several expressed interest in research training in the US as part of their residencies, and we are continuing to correspond. I came from the experience with more than 40 new e-mail correspondents and with new mentoring roles for severOn a Friday in December of 2010, an Italian colleague at the University of Padova School of Medicine informed me that annual competitive grants, sponsored by an Italian regional Bank Foundation (Fondazione Cassa di Risparmio di Padova e Rovigo), were to be made available to non-Italian university faculty in all disciplines to teach courses during the upcoming academic year 2011-12 in Padova. The only challenge was that proposals were due on Sunday, barely two days later. Nonetheless, I outlined a one-month course of 4 hours of daily lecture and case discussion entitled “Fundamentals of Geriatric Medicine.” Mirabile dictu, two months later, I received notice of success; included was the expectation that I give a public lecture during my stay, and of course I eagerly accepted – more about the lecture later. My students were to be residents in geriatrics at varied levels of post-graduate training; it was uncertain how many residents would enroll in my course; I was told to expect 10 to 15. I then began to cope with the need to develop syllabi and slide sets to cover the most important topics in geriatrics. From May through early September, I wrote course materials, and arrived in Padova on October 1 with 20 flash drives loaded with lecture slides, exam questions and references for my future students. Thirty-five residents and varying numbers of faculty began and finished what was to be an exciting, challenging and deeply satisfying month for me. Formal evaluation by the students is in progress, and early results suggest a positive experience for them as well. Although the students were accustomed to the European-style of learning – not as interactive as in the US – we soon spent increasing time in discussion. Still, lectures and working on test questions together were our dominant activity. The single most provocative topic for the students was end-of-life care, including advanced directives and POINT OF VIEW