Roze des Ordons Amanda, Kassam Aliya, Simon Jessica
Department of Critical Care Medicine and Division of Palliative Medicine, University of Calgary Cumming School of Medicine, South Health Campus ICU, 4448 Front St. SE, Calgary, AB, T3M 1M4, Canada.
Office of Postgraduate Medical Education, Cumming School of Medicine, University of Calgary Cumming School of Medicine, Heritage Medical Research Building, Room G02 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada.
BMC Med Educ. 2017 Jan 6;17(1):6. doi: 10.1186/s12909-016-0839-2.
Residents are commonly involved in establishing goals of care for hospitalized patients. While education can improve the quality of these conversations, whether and how postgraduate training programs integrate such teaching into their curricula is not well established. The objective of this study was to characterize perceptions of current teaching and assessment of goals of care conversations, and program director interest in associated curricular integration.
An electronic survey was sent to all postgraduate program directors at the University of Calgary. Quantitative data was analyzed using descriptive statistics and qualitative comments were analyzed using thematic analysis.
The survey response rate was 34% (22/64). Formal goals of care conversation teaching is incorporated into 63% of responding programs, and most commonly involves lectures. Informal teaching occurs in 86% of programs, involving discussion, direct observation and role modeling in the clinical setting. Seventy-three percent of programs assess goals of care conversation skills, mostly in the clinical setting through feedback. Program directors believe that over two-thirds of clinical faculty are prepared to teach goals of care conversations, and are interested in resources to teach and assess goals of care conversations. Themes that emerged include 1) general perceptions, 2) need for teaching, 3) ideas for teaching, and 4) assessment of goals of care conversations.
The majority of residency training programs at the University of Calgary incorporate some goals of care conversation teaching and assessment into their curricula. Program directors are interested in resources to improve teaching and assessment of goals of care conversations.
住院医师通常参与确定住院患者的护理目标。虽然教育可以提高这些沟通的质量，但研究生培训项目是否以及如何将此类教学纳入其课程体系尚未明确。本研究的目的是描述对当前护理目标沟通教学与评估的看法，以及项目主任对相关课程整合的兴趣。
向卡尔加里大学所有研究生项目主任发送了电子调查问卷。定量数据采用描述性统计进行分析，定性评论采用主题分析进行分析。
调查回复率为34%（22/64）。63%的回复项目纳入了正式的护理目标沟通教学，最常见的形式是讲座。86%的项目存在非正式教学，包括在临床环境中的讨论、直接观察和角色扮演。73%的项目评估护理目标沟通技能，主要是在临床环境中通过反馈进行。项目主任认为超过三分之二的临床教员准备好教授护理目标沟通，并且对教授和评估护理目标沟通的资源感兴趣。出现的主题包括：1）总体看法，2）教学需求，3）教学思路，4）护理目标沟通评估。
卡尔加里大学的大多数住院医师培训项目在其课程中纳入了一些护理目标沟通教学与评估。项目主任对改善护理目标沟通教学与评估的资源感兴趣。
