Robinson Katya, Sutton Sharyn, von Gunten Charles F, Ferris Frank D, Molodyko Nicholas, Martinez Jeanne, Emanuel Linda L
The EPEC Project, Buehler Center on Aging, Northwestern University Medical School, Chicago, IL 60611, USA.
J Palliat Med. 2004 Oct;7(5):637-45. doi: 10.1089/jpm.2004.7.637.
Palliative medicine is assuming an increasingly important role in patient care. Yet, most physicians did not learn this during their formal training. The Education for Physicians in End-of-life Care (EPEC) Project aims to increase physician knowledge in palliative care by disseminating the EPEC Curriculum through a train-the-trainer approach. An assessment of its use to help the project reach its targets was performed.
An independent evaluation pursued a two-step qualitative and quantitative approach to assess the ways that the curriculum is used by EPEC Trainers.
The main findings are: (1) The EPEC Curriculum is well regarded by a quota sample of 200 physicians who were trained to use the curriculum between January 1999 and March 2000. When asked, "How would you rate the effect of EPEC training on your knowledge of end-of-life care?," 62% (123/200) selected 'greatly improved it.' When asked, "What was the effect of the EPEC conference on your ability to teach end-of-life care?," 72% (144/200) selected 'greatly improved it.' (2) Dissemination has been effective. Ninety-two percent (184/200) use the curriculum for teaching. Of these, 83% (153/184) presented the material in 30-60 minute sessions as part of regularly scheduled conferences. We estimate that these 184 EPEC Trainers have presented 1 or more of the 16 EPEC Curriculum modules to approximately 120,000 professionals.
There is evidence that physicians selected to be EPEC Trainers judge the EPEC Curriculum to be high in quality, respected, and most importantly, usable. They use the EPEC Curriculum as part of a train-the-trainer dissemination strategy. The interpretation of this enthusiastic assessment is tempered by the study's limitations including respondent bias and possible acquiescence. Nevertheless, it appears that the EPEC Curriculum has set a standard of knowledge in the field and is an example of disseminating new information to physicians in practice. We conclude that the EPEC Curriculum is an effective vehicle to transmit palliative care information to physicians in practice.
姑息医学在患者护理中发挥着越来越重要的作用。然而，大多数医生在正规培训期间并未学习这方面的内容。临终关怀医生教育（EPEC）项目旨在通过培训培训师的方法传播EPEC课程，以增加医生在姑息治疗方面的知识。对其用于帮助该项目实现目标的情况进行了评估。
一项独立评估采用了定性和定量两步法，以评估EPEC培训师使用该课程的方式。
主要发现如下：（1）1999年1月至2000年3月期间接受培训以使用该课程的200名医生的配额样本对EPEC课程评价很高。当被问及“你如何评价EPEC培训对你临终关怀知识的影响？”时，62%（123/200）选择了“极大地提高了”。当被问及“EPEC会议对你教授临终关怀的能力有什么影响？”时，72%（144/200）选择了“极大地提高了”。（2）传播是有效的。92%（184/200）将该课程用于教学。其中，83%（153/184）在30至60分钟的课程中讲授这些材料，作为定期会议的一部分。我们估计，这184名EPEC培训师已向约120,000名专业人员介绍了16个EPEC课程模块中的1个或更多模块。
有证据表明，被选为EPEC培训师的医生认为EPEC课程质量高、受尊重，最重要的是实用。他们将EPEC课程用作培训培训师传播策略的一部分。这项热情的评估的解读受到该研究局限性的影响，包括应答偏差和可能的默许。尽管如此，EPEC课程似乎已经在该领域树立了知识标准，并且是向执业医生传播新信息的一个范例。我们得出结论，EPEC课程是向执业医生传播姑息治疗信息的有效工具。
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