Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
Joan and Sanford I Weill Medical College of Cornell University, New York, New York, USA.
Emerg Med J. 2020 May;37(5):262-264. doi: 10.1136/emermed-2019-208567. Epub 2019 Jul 26.
To explore the impact of an adapted goals-of-care communications skills workshop created for ED physicians from the physicians' perspective.
Semi-structured, one-on-one audio-recorded interviews lasting 30-60 min were conducted with twelve physicians who had completed the training workshop. Interviews explored the experience of undertaking the workshop, its impact on their clinical practice and their ability to teach new skills to other clinicians using learnt techniques. Descriptive content analysis was performed on interview transcripts.
Participants reported positive experiences of the workshop. The analysis identified four main themes and ten subthemes dealing with workshop content and its impact on subsequent ED-based clinical practice. There were: 1) value and future improvements for the course; 2) value of the course to practice; 3) value of the course for teaching residents and 4) barriers to application of learning. Specifically recommended components include the use of mnemonics, mechanisms to introduce difficult conversations and a positive feedback environment. Participant-recommended refinements to the workshop included emphasising urgency, replicating the chaotic ED environment and expanding content to include more ED-focused goals-of-care discussions.
A short, focused training workshop directed at improving palliative care communication skills among ED clinicians appears to be welcomed and useful.
从医生的角度探讨为急诊科医生量身定制的目标关怀沟通技巧培训课程的影响。
对 12 名完成培训课程的医生进行了半结构化、一对一、时长 30-60 分钟的音频记录访谈。访谈内容包括参加培训课程的经历、对他们临床实践的影响以及他们运用所学技巧向其他临床医生传授新技能的能力。对访谈记录进行描述性内容分析。
参与者报告了对该课程的积极体验。分析确定了四个主要主题和十个子主题，涉及课程内容及其对后续基于急诊科的临床实践的影响。主题包括：1）课程的价值和未来改进；2）课程对实践的价值；3）课程对住院医师教学的价值；4）学习应用的障碍。具体推荐的内容包括使用记忆术、引入困难对话的机制和积极的反馈环境。参与者对课程的建议包括强调紧迫性、复制急诊科的混乱环境以及扩大内容以纳入更多以急诊科为重点的目标关怀讨论。
针对急诊科临床医生的短期、重点培训课程似乎受到欢迎且有用，可用于提高姑息治疗沟通技巧。
