School of Medicine, University of Nottingham, Nottingham, UK.
Clinical Psychology, Nottinghamshire Health Care NHS Foundation Trust, Nottingham, UK.
Psychooncology. 2020 Nov;29(11):1786-1793. doi: 10.1002/pon.5393. Epub 2020 Apr 24.
Unaddressed anxiety and depression is common among cancer patients and has significant adverse consequences. Cancer staff training is recommended for psychological assessment and interventions to address depression and anxiety, to increase access to psycho-social oncology care. However, psychological skills training has a poor track-record for improving clinical effectiveness. "Deliberate practice", receiving feedback on therapeutic micro-skills and rehearsing modifications, can enhance clinical effectiveness. This study applied deliberate practice to maximise benefits of brief psychological skills training for cancer care staff.
Seventeen one-day training workshops were provided to 263 cancer care staff, aiming to improve confidence in assessing anxiety and depression, and delivering problem-solving therapy. Training used deliberate practice methods at the expense of didactic lecturing. Staff confidence was assessed in key teaching domains using pre-post confidence ratings. Anonymous comments from 152 training attendees were examined using thematic analysis.
One-day psychological skills training significantly improved cancer staff confidence in assessment of anxiety and depression, and delivery of brief psychological interventions. Thematic analysis indicated that focusing on practical skills was valued by participants and contributed to staff commitments to change practice. However, some participants felt the one-day training was over-filled and would be better delivered over more days.
Similar results can be achieved by providing psychological skills training on a single-day, as compared to an established five-day programme, by abbreviating didactic teaching and focusing time on deliberate practice of skills. Training may increase the likelihood of changes in practice, but more training time may be required for maximum benefit.
癌症患者中普遍存在未得到解决的焦虑和抑郁问题,且其具有严重的不良后果。建议对医务人员进行培训,以便对抑郁和焦虑进行心理评估和干预,从而增加获得心理肿瘤学护理的机会。但是,心理技能培训在提高临床疗效方面的记录不佳。“刻意练习”,即接受治疗微技能的反馈并进行修改演练,可以提高临床疗效。本研究将刻意练习应用于最大限度地提高简短心理技能培训对癌症护理人员的益处。
为 263 名癌症护理人员提供了 17 次为期一天的培训研讨会,旨在提高评估焦虑和抑郁以及实施问题解决疗法的信心。培训使用刻意练习方法,而减少了说教式的讲课。使用预先和事后的信心评分来评估关键教学领域的员工信心。使用主题分析方法来检查 152 名培训参与者的匿名评论。
为期一天的心理技能培训可显著提高癌症工作人员评估焦虑和抑郁以及实施简短心理干预的信心。主题分析表明,参与者重视实用技能,这有助于员工承诺改变实践。但是,一些参与者认为为期一天的培训内容过多,如果能在更多天内进行,则效果会更好。
与既定的五天方案相比,通过缩短说教式教学并专注于技能的刻意练习,在一天内提供心理技能培训也可以取得类似的结果。培训可能会增加实践改变的可能性,但可能需要更多的培训时间才能获得最大收益。