Department of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.
Department of Oncology, Division of Quality of Life and Palliative Care, St Jude Children's Research Hospital, Memphis, Tennessee.
Pediatr Blood Cancer. 2020 Nov;67(11):e28308. doi: 10.1002/pbc.28308. Epub 2020 Jul 30.
Although humanism and professionalism are central tenets to the practice of medicine, few formal curricula exist for medical trainees. Following a national needs assessment among pediatric hematology-oncology (PHO) fellows, we created a novel curriculum entitled "Humanism and Professionalism for Pediatric Hematology-Oncology" (HP-PHO). In this study, we measure outcomes of this curricular intervention.
We cluster-randomized 20 PHO fellowship programs to deliver usual training in humanism and professionalism (UT) or the novel curriculum (intervention) during the 2016-2017 academic year. The primary outcome measure was the Pediatric Hematology-Oncology Self-Assessment in Humanism (PHOSAH). Secondary measures included the Maslach Burnout Inventory, Patient-Provider Orientation Scale, Empowerment at Work Scale, and a 5-point satisfaction scale. Participating fellows completed pre- and posttests at the beginning and end of the academic year, respectively, and we calculated change scores for each study instrument.
Cluster randomization yielded 59 intervention and 41 UT fellows. The nine intervention sites administered 33 of 36 modules. Change scores on the PHOSAH were not significantly different between the UT and intervention arms. However, fellows on the intervention arm gave significantly higher ratings on several items within the satisfaction scale related to physician burnout, physician depression, balancing professional duties and personal life, and humanism overall.
Exposure to the HP-PHO curriculum did not alter fellows' self-assessed humanism and professionalism skills. However, intervention fellows expressed significantly higher levels of satisfaction in their humanism training, indicating the curriculum's potential for positive impact on the fellows' perceived learning environment.
尽管人文主义和专业精神是医学实践的核心原则，但很少有针对医学受训者的正式课程。在对儿科血液学-肿瘤学（PHO）研究员进行全国需求评估后，我们创建了一门名为“儿科血液学-肿瘤学的人文主义和专业精神”（HP-PHO）的新课程。在这项研究中，我们衡量了这一课程干预的结果。
我们将 20 个 PHO 研究员培训计划进行聚类随机分组，以便在 2016-2017 学年提供人文主义和专业精神的常规培训（UT）或新的课程（干预）。主要结果衡量标准是儿科血液学-肿瘤学人文主义自我评估（PHOSAH）。次要措施包括马斯拉赫倦怠量表、患者-提供者取向量表、工作赋权量表和 5 分满意度量表。参与的研究员分别在学年开始和结束时完成了预测试和后测试，并计算了每个研究工具的变化分数。
聚类随机分组产生了 59 名干预组和 41 名 UT 研究员。9 个干预地点共管理了 36 个模块中的 33 个。UT 和干预组的 PHOSAH 变化分数没有显著差异。然而，干预组的研究员在与医生倦怠、医生抑郁、平衡专业职责和个人生活以及整体人文主义相关的满意度量表中的几个项目上给予了显著更高的评分。
暴露于 HP-PHO 课程并没有改变研究员自我评估的人文主义和专业精神技能。然而，干预组的研究员在他们的人文主义培训中表达了显著更高的满意度水平，表明该课程有可能对研究员的感知学习环境产生积极影响。
