Rush University Medical Center, Chicago, Illinois, USA.
University of Chicago Medical Center, Chicago, Illinois, USA.
J Pain Symptom Manage. 2020 Sep;60(3):602-612. doi: 10.1016/j.jpainsymman.2020.03.036. Epub 2020 Apr 7.
The disparity between gaps in workforce and availability of palliative care (PC) services is an increasing issue in health care. To meet the demand, team-based PC requires additional educational training for all clinicians caring for persons with serious illness.
To describe the educational methodology and evaluation of an existing regional interdisciplinary PC training program that was expanded to include chaplain and social worker trainees.
From 2015 to 2017, 26 social workers, chaplains, physicians, nurses, and advanced practice providers representing 22 health systems completed a two-year training program. The curriculum comprises biannual interdisciplinary conferences, individualized mentoring and clinical shadowing, self-directed e-learning, and profession-focused seminar series for social workers and chaplains. Site-specific practice improvement projects were developed to address gaps in PC at participating sites.
PC and program development skills were self-assessed before and after training. Among 12 skills common to all disciplines, trainees reported significant increases in confidence across all 12 skills and significant increases in frequency of performing 11 of 12 skills. Qualitative evaluation identified a myriad of program strengths and challenges regarding the educational format, mentoring, and networking across disciplines.
Teaching PC and program development knowledge and skills to an interdisciplinary regional cohort of practicing clinicians yielded improvements in clinical skills, implementation of practice change projects, and a sense of belonging to a supportive professional network.
劳动力差距与姑息治疗 (PC) 服务的可及性之间的差距是医疗保健中日益严重的问题。为了满足需求，基于团队的 PC 需要对所有照顾重病患者的临床医生进行额外的教育培训。
描述一项现有的区域跨学科 PC 培训计划的教育方法和评估，该计划已扩大范围，包括牧师和社会工作者学员。
2015 年至 2017 年，26 名代表 22 个医疗系统的社会工作者、牧师、医生、护士和高级执业医师完成了为期两年的培训计划。课程包括双年度跨学科会议、个性化指导和临床跟班学习、自我指导的电子学习以及针对社会工作者和牧师的专业研讨会系列。根据参与地点的具体情况，制定了特定地点的实践改进项目，以解决 PC 中的差距。
培训前后，对姑息治疗和方案制定技能进行了自我评估。在所有学科共有的 12 项技能中，学员报告称，在所有 12 项技能中的信心都有显著提高，在 12 项技能中的 11 项技能的执行频率也有显著提高。定性评估确定了教育形式、指导和跨学科网络方面的众多计划优势和挑战。
向跨学科的区域实践临床医生群体教授姑息治疗和方案制定知识和技能，可提高临床技能、实施实践变革项目，并增强对支持性专业网络的归属感。
