Respecting Patient Choices, Austin Health, Heidelberg, Victoria, Australia.
Respecting Patient Choices, Barwon Health School of Medicine, Deakin University, Victoria, Australia.
BMJ Support Palliat Care. 2014 Sep;4(3):313-21. doi: 10.1136/bmjspcare-2013-000450. Epub 2014 May 20.
To develop and evaluate an interactive advance care planning (ACP) educational programme for general practitioners and doctors-in-training.
Development of training materials was overseen by a committee; informed by literature and previous teaching experience. The evaluation assessed participant confidence, knowledge and attitude toward ACP before and after training.
Training provided to metropolitan and rural settings in Victoria, Australia.
148 doctors participated in training. The majority were aged at least 40 years with more than 10 years work experience; 63% had not trained in Australia.
The programme included prereading, a DVD, interactive patient e-simulation workshop and a training manual. All educational materials followed an evidence-based stepwise approach to ACP: Introducing the topic, exploring concepts, introducing solutions and summarising the conversation.
The primary outcome was the change in doctors' self-reported confidence to undertake ACP conversations. Secondary measures included pretest/post-test scores in patient ACP e-simulation, change in ACP knowledge and attitude, and satisfaction with programme materials.
69 participants completed the preworkshop and postworkshop evaluation. Following education, there was a significant change in self-reported confidence in six of eight items (p=0.008 -0.08). There was a significant improvement (p<0.001) in median scores on the e-simulation (pre 7/80, post 60/80). There were no significant differences observed in ACP knowledge following training, and most participants were supportive of patient autonomy and ACP pretraining. Educational materials were rated highly.
A short multimodal interactive education programme improves doctors' confidence with ACP and performance on an ACP patient e-simulation.
为全科医生和实习医生开发和评估一种交互式的预先护理计划（ACP）教育计划。
培训材料的开发由一个委员会监督；参考文献和以前的教学经验。评估在培训前后评估参与者对 ACP 的信心、知识和态度。
在澳大利亚维多利亚州的城市和农村地区提供培训。
148 名医生参加了培训。大多数人年龄至少 40 岁，工作经验超过 10 年；63%的人没有在澳大利亚接受过培训。
该计划包括预习、DVD、互动式患者电子模拟工作坊和培训手册。所有教育材料都遵循基于证据的逐步 ACP 方法：介绍主题、探索概念、介绍解决方案和总结对话。
主要结果是医生自我报告进行 ACP 对话的信心变化。次要测量包括患者 ACP 电子模拟的预测试/后测试分数、ACP 知识和态度的变化以及对计划材料的满意度。
69 名参与者完成了预研讨会和研讨会后的评估。教育后，在八项中的六项中，自我报告的信心有显著变化（p=0.008-0.08）。电子模拟的中位数得分有显著提高（p<0.001）（预 7/80，后 60/80）。培训后 ACP 知识没有显著差异，大多数参与者支持患者自主权和 ACP 预培训。教育材料的评价很高。
一个简短的多模式互动教育计划提高了医生对 ACP 的信心和 ACP 患者电子模拟的表现。
