David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.
Palliative Care Program, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
J Palliat Med. 2021 Mar;24(3):354-375. doi: 10.1089/jpm.2020.0293. Epub 2020 Jul 8.
The medical profession increasingly recognizes the growing need to educate nonpalliative physicians in palliative care. This study aims to provide a scoping review of the primary palliative care (PPC) education currently available to graduate medical trainees in primary and specialty tracks. Studies of PPC interventions in U.S. residency or fellowship programs of all subspecialties published in English and listed on MEDLINE, CINAHL, and EMBASE through January 2020 were included. To meet admission criteria, studies had to describe the content, delivery methods, and evaluation instruments of a PPC educational intervention. Of 233 eligible full texts, 85 studies were included for assessment, of which 66 were novel PPC educational interventions and 19 were standard education. Total number of publications evaluating PPC education increased from 8 (2000-2004) to 36 (2015-2019), across 11 residency and 10 fellowship specialties. Residency specialties representing the majority of publications were emergency medicine, general surgery, internal medicine, and pediatric/medicine-pediatrics. PPC content domains most taught in residencies were communication and symptom management; the primary delivery method was didactics, and the outcome assessed was attitudes. Fellowship specialties representing the majority of publications were pediatric subspecialties, nephrology, and oncology. The PPC content domain most taught in fellowships was communication; the primary delivery method was didactics and the outcome evaluated was attitudes. While PPC education has increased, it remains varied in content, delivery method, and intervention evaluations. Future studies should include more widespread evaluation of behavioral outcomes, longitudinal persistence of use, and clinical impact.
医疗行业越来越认识到，需要加强对非姑息治疗医生的姑息治疗教育。本研究旨在对初级和专科轨道的研究生医学实习生目前可获得的主要姑息治疗（PPC）教育进行范围界定审查。纳入了在美国居住或研究员课程中发表的所有亚专业的 PPC 干预研究，这些研究以英语发表，并在 MEDLINE、CINAHL 和 EMBASE 上列出，时间截止到 2020 年 1 月。为了符合入学标准，研究必须描述 PPC 教育干预的内容、交付方法和评估工具。在 233 篇符合条件的全文中，有 85 篇被评估，其中 66 篇是新的 PPC 教育干预措施，19 篇是标准教育。评估 PPC 教育的出版物总数从 2000-2004 年的 8 篇增加到 2015-2019 年的 36 篇，涉及 11 个居住专业和 10 个研究员专业。代表大多数出版物的居住专业是急诊医学、普通外科、内科和儿科/儿科学。居住专业中教授最多的 PPC 内容领域是沟通和症状管理；主要的教学方法是讲座，评估的结果是态度。代表大多数出版物的研究员专业是儿科亚专业、肾脏病学和肿瘤学。在研究员专业中教授最多的 PPC 内容领域是沟通；主要的教学方法是讲座，评估的结果是态度。虽然 PPC 教育有所增加，但在内容、教学方法和干预评估方面仍然存在差异。未来的研究应包括更广泛地评估行为结果、使用的纵向持久性和临床影响。
