S. Sinclair is associate professor and director, Compassion Research Lab, Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
J. Kondejewski is research assistant, Compassion Research Lab, Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
Acad Med. 2021 Jul 1;96(7):1057-1070. doi: 10.1097/ACM.0000000000004114.
To investigate the current state and quality of compassion education interventions offered to health care providers during training or practice, determine how the components of each education intervention map onto the domains of an empirically based clinical model of compassion, and identify the most common approaches to compassion education.
The MEDLINE, Embase, CINAHL Plus with Full Text, Sociological Abstracts, Web of Science, ERIC, and Education Research Complete databases were searched from inception to March 2020 in this systematic review. Studies that evaluated a compassion education intervention for health care providers or those in training to enhance compassion toward patients and/or families were included. A narrative synthesis of the included studies was performed. The components of each intervention were mapped onto the domains of compassion described in the Patient Compassion Model.
One hundred eight peer-reviewed publications describing 103 interventions were included. Modalities ranged from establishing curricula and interventions in clinical settings to programs that used humanities-based reflective practices, clinical simulation, role modeling, and contemplative practices, with many education interventions adopting a multimodal approach. Most interventions mapped to the virtuous response domain of the Patient Compassion Model; very few mapped to the other domains of this model.
Most interventions were limited as they focused on a single domain of compassion; did not adequately define compassion; were assessed exclusively by self-report; were devoid of a comparator/control group; and did not evaluate retention, sustainability, and translation to clinical practice over time. The authors suggest that compassion education interventions be grounded in an empirically based definition of compassion; use a competency-based approach; employ multimodal teaching methods that address the requisite attitudes, skills, behaviors, and knowledge within the multiple domains of compassion; evaluate learning over time; and incorporate patient, preceptor, and peer evaluations.
调查目前在培训或实践中向医疗保健提供者提供的同情教育干预措施的现状和质量，确定每个教育干预措施的组成部分如何映射到基于实证的同情临床模型的各个领域，并确定同情教育最常见的方法。
本系统评价从 MEDLINE、Embase、CINAHL Plus with Full Text、Sociological Abstracts、Web of Science、ERIC 和 Education Research Complete 数据库中检索了从开始到 2020 年 3 月的文献。纳入评估针对医疗保健提供者或接受培训以增强对患者和/或家属的同情心的同情教育干预措施的研究。对纳入的研究进行了叙述性综合分析。将每个干预措施的组成部分映射到患者同情模型中描述的同情各个领域。
纳入了 108 篇描述 103 项干预措施的同行评审出版物。模式范围从在临床环境中建立课程和干预措施到使用人文反思实践、临床模拟、角色扮演和冥想实践的计划，许多教育干预措施采用了多模式方法。大多数干预措施映射到患者同情模型的良性反应领域；很少有映射到该模型的其他领域。
大多数干预措施都受到限制，因为它们仅关注同情的单个领域；没有充分定义同情；仅通过自我报告进行评估；缺乏对照组/对照组；并且没有评估随着时间的推移保留、可持续性和向临床实践的转化。作者建议同情教育干预措施基于对同情的实证定义；使用基于能力的方法；采用多模式教学方法，解决同情的多个领域所需的态度、技能、行为和知识；随着时间的推移评估学习情况；并纳入患者、导师和同伴的评估。
