为儿科住院医师创建和评估癌症生存课程。
Creation and evaluation of a cancer survivorship curriculum for pediatric resident physicians.
机构信息
University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA.
University of California, Los Angeles, 885 Tiverton Avenue, Los Angeles, CA, 90024, USA.
出版信息
J Cancer Surviv. 2018 Oct;12(5):651-658. doi: 10.1007/s11764-018-0702-z. Epub 2018 Jun 25.
PURPOSE
There is a paucity of formal clinician education concerning cancer survivorship care, which produces care barriers and poorer outcomes for survivors of childhood cancer. To address this, we implemented a curriculum in childhood cancer survivorship care for pediatric residents at the University of California, Los Angeles (UCLA). We examined the efficacy of this curriculum following program completion.
METHODS
A case-based curriculum was created and integrated within existing educational structures using Kern's model. We utilized the retrospective pre-posttest method to evaluate participating residents' knowledge, clinical skills, and attitudes towards cancer survivorship topics before and after receiving the curriculum. Pre-posttest items were compared using paired t tests and one-sided binomial tests. We analyzed free-response question items for major themes using constant comparative methods.
RESULTS
Thirty-four residents completed the curriculum and its evaluation. Each assessment item significantly increased from pre- to post-curriculum; p < 0.05. Greater than 40% of residents improved in all but one assessment item post-curriculum; p < 0.05. Residents reported the curriculum enhanced their pediatric knowledge base (M = 3.24; SD = 0.65) and would recommend it to other residency programs; M = 3.24; SD = 0.69. Major themes included residents' request for additional oncofertility information, training in counseling survivors, and cancer survivorship training opportunities.
CONCLUSIONS
A cancer survivorship curriculum can successfully increase trainees' knowledge, clinical skills, and comfort in discussing topics relevant to survivorship care.
IMPLICATIONS FOR CANCER SURVIVORS
With increasing numbers of childhood cancer survivors living into adulthood, residents will likely treat this population regardless of intended career path. This curriculum represents one method to deliver formal cancer survivorship training.
目的
针对癌症生存者护理方面，临床医生接受的正规培训十分有限，这导致了生存者的护理障碍和较差的预后。为了解决这个问题，我们为加利福尼亚大学洛杉矶分校（UCLA）的儿科住院医师实施了儿童癌症生存者护理课程。我们在项目完成后，检查了该课程的效果。
方法
使用 Kern 模型，我们创建了一个基于案例的课程，并将其整合到现有的教育结构中。我们采用回顾性前后测试法，在接受课程前后，评估参与的住院医师对癌症生存者主题的知识、临床技能和态度。使用配对 t 检验和单边二项式检验比较前后测试项目。我们使用恒定比较方法对自由回答问题项目进行主要主题分析。
结果
34 名住院医师完成了课程及其评估。每个评估项目的得分都从课前到课后显著提高；p<0.05。除了一项评估项目外，所有项目在课后都有超过 40%的住院医师提高；p<0.05。住院医师报告说，课程增强了他们的儿科知识基础（M=3.24；SD=0.65），并会向其他住院医师课程推荐；M=3.24；SD=0.69。主要主题包括住院医师对额外肿瘤生育信息的需求、对幸存者咨询的培训以及癌症生存者培训机会。
结论
癌症生存者课程可以成功提高受训者在与生存者护理相关主题方面的知识、临床技能和舒适度。
对癌症生存者的影响
随着越来越多的儿童癌症幸存者进入成年期，无论其职业规划如何，住院医师都可能会治疗这一人群。本课程代表了提供正规癌症生存者培训的一种方法。
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