Starks Helene, Coats Heather, Paganelli Tia, Mauksch Larry, van Schaik Eileen, Lindhorst Taryn, Hurd Caroline, Doorenbos Ardith
1 Department of Bioethics and Humanities, School of Medicine, University of Washington, Seattle, WA, USA.
2 Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, USA.
Am J Hosp Palliat Care. 2018 Mar;35(3):390-397. doi: 10.1177/1049909117725042. Epub 2017 Aug 10.
The National Consensus Project for Quality Palliative Care Clinical Practice Guidelines recommend that palliative care clinicians work together as interprofessional teams. We created and piloted a 9-month curriculum that focused on 3 related domains: (1) patient-centered, narrative communication skills; (2) interprofessional team practice; and (3) metrics and systems integration. The multifaceted curriculum was delivered through 16 webinars, 8 online modules, 4 in-person workshops, reflective skill practice, written reflections, and small group online discussions.
Report evaluations of the course content and skill self-assessments from 24 interprofessional palliative care clinicians.
Participants rated each learning activity and completed a retrospective pre-post test skill assessment. Learning gains were measured as the difference in the percentage of participants reporting "strong" or "highly competent" skill levels at baseline and the end of the course. Participants also provided examples of how they used the skills in practice.
Participants achieved an average learning gain of 50% across all domains, and in each domain communication (54%), interprofessional team practice (52%), and metrics and systems integration (34%). They also gave high ratings for the curriculum content (overall mean [standard deviation] rating of 5.5 (0.7) out of 6). Examples of practice impacts included improved skills in responding to emotions, understanding the equal importance of all professions on their team and incorporating different perspectives into their practice, and learning about outcome measurement in palliative care.
This curriculum demonstrated success in increasing perceived skills for interprofessional palliative care clinicians in advanced communication, team practice, and metrics and system integration.
国家姑息治疗质量共识项目临床实践指南建议姑息治疗临床医生作为跨专业团队共同协作。我们创建并试行一项为期9个月的课程，该课程聚焦于3个相关领域：（1）以患者为中心的叙事沟通技巧；（2）跨专业团队实践；（3）指标与系统整合。这一多维度课程通过16次网络研讨会、8个在线模块、4次面对面工作坊、反思技能实践、书面反思以及小组在线讨论来实施。
报告24名跨专业姑息治疗临床医生对课程内容的评价以及技能自我评估情况。
参与者对每项学习活动进行评分，并完成一项回顾性的前后测技能评估。学习收获通过比较参与者在基线时和课程结束时报告“强”或“高度胜任”技能水平的百分比差异来衡量。参与者还提供了他们在实践中如何运用这些技能的示例。
参与者在所有领域平均获得了50%的学习收获，在各个领域中，沟通方面（54%）、跨专业团队实践方面（52%）以及指标与系统整合方面（34%）。他们对课程内容也给予了高度评价（总体平均[标准差]评分为6分中的5.5（0.7）分）。实践影响的示例包括在应对情绪方面技能的提高、理解团队中所有专业同等重要并将不同观点融入其实践，以及了解姑息治疗中的结果测量。
该课程在提高跨专业姑息治疗临床医生在高级沟通、团队实践以及指标与系统整合方面的感知技能方面取得了成功。
