Department of Palliative Medicine, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
Palliat Med. 2012 Sep;26(6):851-7. doi: 10.1177/0269216311416696. Epub 2011 Aug 10.
The ability to provide good palliative care to patients is increasingly recognised as a core clinical skill that all doctors should possess. Few junior doctors, however, feel competent in breaking bad news, pain relief and the care of dying patients by the time they are fully registered to practice.
The aim of this study was to explore doctors' experiences in foundation year 1 (F1) palliative medicine posts.
Participants underwent semi-structured interviews and interview transcripts were analysed using Interpretative Phenomenological Analysis.
SETTING/PARTICIPANTS: The study involved a purposive sample of six F1 doctors matched in 2005-2006 to rotations incorporating palliative medicine posts at two acute hospital National Health Service (NHS) Trusts and one NHS hospice in the UK.
F1 doctors were satisfied with the learning opportunities provided by the posts, which achieved the right balance between supported and autonomous working. They described learning through their day-to-day interactions with staff, including specialist nurses, and by practising their skills on the job. Some struggled, however, to make the transition to a more independent learning style in the clinical environment. Trainees felt the post helped them to develop generic skills, such as symptom control, diagnosing dying and breaking bad news. Whilst they found split posts and on-call rotas disrupted their palliative care learning, these offered important opportunities to learn additional F1 skills.
F1 posts in palliative medicine in the UK have positive influences on perceived generic skills development and practice. These findings might encourage the development of more rotations incorporating palliative medicine in the future.
越来越多的人认识到，为患者提供良好的姑息治疗能力是所有医生都应具备的核心临床技能。然而，很少有初级医生在完全注册执业时，在告知坏消息、缓解疼痛和照顾临终患者方面感到有能力。
本研究旨在探讨初级医生在第一年基础医学（F1）姑息医学岗位上的经历。
参与者接受半结构化访谈，访谈记录采用解释性现象学分析进行分析。
地点/参与者：本研究涉及英国两家急症医院国民保健服务（NHS）信托机构和一家 NHS 临终关怀机构的姑息医学岗位中 2005-2006 年配对的六名 F1 医生的目的性抽样。
F1 医生对岗位提供的学习机会感到满意，这些机会在支持性和自主性工作之间取得了适当的平衡。他们通过与包括专科护士在内的工作人员的日常互动，以及在工作中实践技能来学习。然而，有些人在临床环境中难以过渡到更独立的学习方式。学员们认为该岗位有助于他们发展通用技能，如症状控制、诊断临终和告知坏消息。虽然他们发现分部岗位和轮班制度打乱了他们的姑息治疗学习，但这些为学习额外的 F1 技能提供了重要机会。
英国姑息医学 F1 岗位对通用技能发展和实践有积极影响。这些发现可能鼓励未来发展更多包含姑息医学的轮转岗位。
