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克恩六步法在围手术期代码状态及护理目标讨论新型麻醉学课程开发中的应用

Application of Kern's 6-Step Approach in the Development of a Novel Anesthesiology Curriculum for Perioperative Code Status and Goals of Care Discussions.

作者信息

Robertson Amy C, Fowler Leslie C, Niconchuk Jon, Kreger Michael, Rickerson Elizabeth, Sadovnikoff Nicholas, Hepner David L, Bader Angela M, Mcevoy Matthew D, Urman Richard D

出版信息

J Educ Perioper Med. 2019 Jan 1;21(1):E634. eCollection 2019 Jan-Mar.

Abstract

BACKGROUND

Code status discussions, goals of care discussions, and shared decision-making in the perioperative setting are of great importance. As perioperative physicians, anesthesiologists are uniquely poised to handle these discussions. Yet formal training for anesthesiology residents in how to approach these scenarios is currently lacking.

METHODS

Using Kern's 6-step approach to curriculum development, we describe an innovative curriculum for anesthesiology residents designed to teach the necessary skills to successfully conduct code status and goals of care discussions and to assess its efficacy.

RESULTS

Our curriculum is composed of the following educational components: (1) formal, online learning modules, (2) selected journal articles describing code status and goals of care discussions skills and communication strategies, and (3) 2 objective-structured clinical examination experiences, with 1 occurring prior to and the other occurring after completion of the educational content. The educational content focuses on evidence-based best practices content covering professional guidelines, current literature, shared decision-making, and effective communication strategies. We also describe the potential methodology to evaluate the effectiveness of our proposed educational interventions.

CONCLUSION

Using Kern's framework, we developed a curriculum focusing on code status discussions, goals of care discussions, and shared decision-making in the perioperative setting which provides trainees with the opportunity to practice communication skills and receive feedback from a standardized patient through participation in an objective structured clinical examination.

摘要

背景

围手术期的病情告知讨论、医疗护理目标讨论以及共同决策至关重要。作为围手术期医生,麻醉医生在处理这些讨论方面具有独特的优势。然而,目前麻醉住院医师缺乏关于如何应对这些情况的正规培训。

方法

我们采用克恩的六步课程开发方法,描述了一种针对麻醉住院医师的创新课程,旨在教授成功进行病情告知和医疗护理目标讨论所需的技能,并评估其效果。

结果

我们的课程由以下教育组件组成:(1)正式的在线学习模块,(2)精选的描述病情告知和医疗护理目标讨论技能及沟通策略的期刊文章,以及(3)两次客观结构化临床考试体验,一次在教育内容完成之前进行,另一次在完成之后进行。教育内容侧重于基于证据的最佳实践内容,涵盖专业指南、当前文献、共同决策和有效的沟通策略。我们还描述了评估我们提出的教育干预措施有效性的潜在方法。

结论

利用克恩的框架,我们开发了一门专注于围手术期病情告知讨论、医疗护理目标讨论和共同决策的课程,该课程为学员提供了通过参与客观结构化临床考试来练习沟通技能并从标准化患者那里获得反馈的机会。

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