Palliative Medicine Consultants, 142935Hospice and Community Care, Lancaster, PA, USA.
Section of General Medicine, Department of Medicine, 12228Yale School of Medicine, New Haven, CT, USA.
Am J Hosp Palliat Care. 2021 Apr;38(4):326-331. doi: 10.1177/1049909120954807. Epub 2020 Sep 3.
There is a need for improved primary palliative care (PC) education and resident comfort with providing end-of-life care.
Utilize a new instrument derived from published PC competencies to assess baseline Internal Medicine (IM) resident knowledge and self-efficacy in PC to identify educational gaps and create new PC curricula.
We created a 2-part instrument including a Knowledge Test (KT) and a Self-Efficacy Inventory (SEI) addressing 18 PC resident competencies across 5 domains: Pain and Symptom Management (PSM), Communication (COMM), Psychosocial, Spiritual, and Cultural Aspects of Care (PSC), Terminal Care and Bereavement (TCB), and Palliative Care Principles and Practice (PCPP).
SETTING/SUBJECTS: The instrument was emailed to IM residents at our institution during academic years 2015-2016 and 2016-2017.
Basic descriptive statistics were performed for the KT and SEI. Mean Rank Analysis and One-way ANOVA were utilized for the KT and SEI, respectively. Congruence was calculated between knowledge and self-efficacy.
The mean score on the KT was 73% (range 33-80%). There was no significant difference in knowledge among post-graduate year cohorts. Self-efficacy scores were lower for interns overall and in PCPP, TCB, and COMM domains. Knowledge was concordant with self-efficacy in 42% of participants, higher than self-efficacy in 10% of participants, and lower than self-efficacy in 48% of participants.
For approximately half of respondents, high self-efficacy in PC did not correlate with high PC knowledge. A more focused curriculum is needed to help IM residents facilitate mastery of PC competencies by graduation.
需要提高初级姑息治疗（PC）教育水平，提高住院医师提供临终关怀的舒适度。
利用一项新的源自已发表的 PC 能力的工具，评估内科住院医师（IM）在 PC 方面的基础知识和自我效能，以确定教育差距并创建新的 PC 课程。
我们创建了一个由两部分组成的工具，包括知识测试（KT）和自我效能量表（SEI），涵盖 5 个领域的 18 个 PC 住院医师能力：疼痛和症状管理（PSM）、沟通（COMM）、心理社会、精神和文化方面的护理（PSC）、终末期护理和丧亲（TCB）以及姑息治疗原则和实践（PCPP）。
设置/受试者：该工具在我们机构的 IM 住院医师在 2015-2016 学年和 2016-2017 学年期间通过电子邮件发送。
对 KT 和 SEI 进行基本描述性统计。分别对 KT 和 SEI 进行均值秩分析和单因素方差分析。计算知识与自我效能之间的一致性。
KT 的平均得分为 73%（范围为 33-80%）。不同研究生年级的知识水平没有显著差异。总体而言，实习医生在自我效能方面得分较低，在 PCPP、TCB 和 COMM 领域得分较低。知识与自我效能在 42%的参与者中一致，高于自我效能的 10%，低于自我效能的 48%。
对于大约一半的受访者来说，PC 方面的高自我效能并不与高 PC 知识相关。需要更有针对性的课程来帮助 IM 住院医师在毕业前掌握 PC 能力。
