Activity Description
Physicians and other health care professionals practicing in today's culturally diverse society face significant challenges when they treat patients with different beliefs, values, and views of health care. These differences are often exacerbated at the end of life. This monograph presents practical strategies for the provision of culturally and linguistically competent end-of-life care.

Target Audience
Physicians and other health care providers who encounter end-of-life issues in their delivery of health care.

Method of Participation
Participants should register for the course, take the pretest, answer the multiple-choice posttest questions, and complete the evaluation to receive a certificate online immediately upon completion.

Learning Objectives
Following completion of this educational activity, learners should be able to:

  • Describe the diversity of the U.S. population and describe its impact on end-of-life care
  • Define “culture” and “cultural and linguistic competency”
  • Discuss specific cultural challenges which may arise in end-of-life care
  • Identify guidelines for medical language interpretation and access appropriate resources on interpretative services and cultural issues
  • Delineate the advantages of proactive communication and care planning in a cross-cultural context
  • Describe strategies for building trust and improving communication
  • Recognize the seven steps for negotiating end-of-life care

Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of California, San Diego School of Medicine and the Continuing Education Alliance. The University of California, San Diego School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

AMA: The University of California, San Diego School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAFP: This activity has been reviewed and is acceptable for up to 1 Prescribed Credit by the American Academy of Family Physicians. AAFP accreditation begins 3/1/2010. Term of approval is 2 years from this date.

BBS: Course meets the qualifications for hour per hour of continuing education credit for MFTs and/or LCSWs as required by the California Board of Behavioral Sciences.

BRN: For the purpose of recertification, the American Nurses Credentialing Center accepts AMA PRA Category 1 Credits™ issued by organizations accredited by the ACCME. For the purpose of relicensure, the California Board of Registered Nursing accepts AMA PRA Category 1 Credits™ (report up to 1.0 hour of credit and list “CME Category 1” as the provider number).

CA Board of Pharmacy: Pharmacists should apply directly to their State Board for course approval.

NHAP: Approved by the Nursing Home Administrator program for 1.0 hour of continuing education credit - NHAP #1612001-8234/P.

RCFE: This activity has been approved by the CDSS for one (1) hour of continuing education units for administrative recertification. Course Number: RCFE 153-0105-16111

Release Date: March 1, 2010
Expiration Date: February 28, 2013


Chief Editor:
Steven Oppenheim, MD
Clinical Medical Director, San Diego Hospice
IRB Chair at the Institute of Palliative Medicine
Associate Professor of Medicine
UC San Diego
San Diego, California

Editorial Board

Marita Grudzen, RT, MHS
Deputy Director, Stanford Geriatric Education Center
Lecturer, Division of Family and Community Medicine
Stanford University School of Medicine
Stanford, California

Shena Russell-McComb, MSW
San Diego Hospice
San Diego, California

Takako J. Radom, MSW
San Diego Hospice
San Diego, California

Madeleine S. Toland, RN, BSN, PHN
San Diego Hospice
San Diego, California

Charles F. von Gunten, MD, PhD, FACP
Provost and Vice President, Institute for Palliative Medicine
Associate Clinical Professor of Medicine
UC San Diego
San Diego, California

Balance and Objectivity of Content
It is the policy of the University of California, San Diego School of Medicine to ensure balance, independence, objectivity and scientific rigor. All persons involved in the selection, development and presentation of content are required to disclose any real or apparent conflicts of interest. All conflicts of interest will be resolved prior to an educational activity being delivered to learners through one of the following mechanisms 1) altering the financial relationship with the commercial interest, 2) altering the individual’s control over CME content about the products or services of the commercial interest, and/or 3) validating the activity content through independent peer review. All persons are also required to disclose any discussions of off label/unapproved uses of drugs or devices. Persons who refuse or fail to complete this form will be disqualified from participating in the CME activity.

The following faculty indicated they have no financial relationships with commercial interests relevant to the content of this activity.

Marita Grudzen, RT, MHS
Shena Russell-McComb, MSW
Steven Oppenheim, MD
Takako J. Radom, MSW
Madeleine Toland, RN, BSN, PHN
Charles F. von Gunten, MD, PhD, FACP

The medical writer who developed the content has no financial relationships with commercial interests relevant to the content of this activity.

The CME staff, meeting planners, planning committee and CME committee reviewers do not have any relevant financial relationships to disclose.

Off-label Disclosure
This educational activity does not contain discussion of unlabeled and/or investigational uses of agents that are not approved by the FDA.

Pain Management
California legislation (AB487) requires physicians complete 12 hours continuing medical education in Pain Management and Palliative Care.  This program offers up to 1 hour on these topics.

Cultural Competency
This activity is in compliance with California Assembly Bill 1195 which requires CME courses with patient care components to include curriculum in the subjects of cultural and linguistic competencies. Cultural and Linguistic Competency was incorporated into the planning of this activity. Additional resources on cultural and linguistic competency and information about AB1195 can be found by viewing the resources link on this website, or on the UCSD CME website at

Supported by educational grants from:    

UC San Diego School of Medicine
Continuing Medical Education
9500 Gilman Drive, MC0947, La Jolla, CA 92093-0947

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