同伴指导在教授初级姑息治疗技能中的新应用：指导咨询。
A Novel Use of Peer Coaching to Teach Primary Palliative Care Skills: Coaching Consultation.
机构信息
Division of Palliative Care and Geriatrics, Massachusetts General Hospital, Harvard Medical School, Boston.
Division of Palliative Care and Geriatrics, Massachusetts General Hospital, Harvard Medical School, Boston.
出版信息
J Pain Symptom Manage. 2017 Oct;54(4):578-582. doi: 10.1016/j.jpainsymman.2017.07.008. Epub 2017 Jul 15.
BACKGROUND
We aim to address palliative care workforce shortages by teaching clinicians how to provide primary palliative care through peer coaching.
INTERVENTION
We offered peer coaching to internal medicine residents and hospitalists (attendings, nurse practioners, and physician assistants).
MEASURES
An audit of peer coaching encounters and coachee feedback to better understand the applicability of peer coaching in the inpatient setting to teach primary palliative care.
OUTCOMES
Residents and hospitalist attendings participated in peer coaching for a broad range of palliative care-related questions about pain and symptom management (44%), communication (34%), and hospice (22%). Clinicians billed for 68% of encounters using a time-based billing model. Content analysis of coachee feedback identified that the most useful elements of coaching are easy access to expertise, tailored teaching, and being in partnership.
CONCLUSION/LESSONS LEARNED: Peer coaching can be provided in the inpatient setting to teach primary palliative care and potentially extend the palliative care work force.
背景
我们旨在通过教授临床医生如何通过同行指导来提供初级姑息治疗，以解决姑息治疗劳动力短缺的问题。
干预措施
我们为内科住院医师和医院医师（主治医生、护士从业者和医师助理）提供了同行指导。
措施
对同行指导的情况进行审计，并对指导对象的反馈进行评估，以更好地了解在住院环境中使用同行指导来教授初级姑息治疗的适用性。
结果
住院医师和医院主治医生参加了同行指导，内容涵盖广泛的姑息治疗相关问题，包括疼痛和症状管理（44%）、沟通（34%）和临终关怀（22%）。医生们使用基于时间的计费模式为 68%的会诊计费。对指导对象反馈的内容分析表明，指导最有用的方面是专家的便捷获取、量身定制的教学和合作关系。
结论/经验教训：可以在住院环境中提供同行指导，以教授初级姑息治疗，并可能扩大姑息治疗的劳动力队伍。
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