Feeney Yvonne, Daley Stephanie, Flaherty Breda, Banerjee Sube
Department of Neuroscience, Brighton and Sussex Medical School, Centre for Dementia Studies, Trafford Centre for Medical Research, University of Sussex, Falmer, Brighton, BN1 9RY, UK.
Department of Medical Education, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, Brighton, BN1 9PH, UK.
BMC Med Educ. 2021 Apr 9;21(1):201. doi: 10.1186/s12909-021-02632-9.
As the numbers of people with dementia worldwide rises, there is a need for improved knowledge and awareness about the condition across the healthcare workforce. There are concerns that traditional models of healthcare education, which focus on short-term episodes of care, limit student understanding of long-term conditions. We therefore designed and delivered the Time for Dementia programme at five Universities in the UK. Through longitudinal contact with families living with dementia, healthcare students gain increased understanding about the experiences of living with dementia. However, implementing new educational models brings challenges. To enable implementation of similar programmes in other educational institutions, this study aimed to identify the common barriers and facilitators of implementing these types of longitudinal programmes at scale.
To understand the facilitators and barriers of implementing a longitudinal dementia educational programme, a qualitative study was completed. Between October and December 2018, twelve in-depth semi-structured interviews were completed with university teaching staff (n = 6), programme administrators (n = 4), and Alzheimer's Society staff (n = 2) that had key responsibilities for implementing Time for Dementia. Interview questions explored participants experiences, the facilitators, and the challenges encountered when implementing the programme. Interviews were audio recorded, transcribed verbatim, and analysed using inductive thematic analysis.
The analysis identified five key themes: "Leadership characteristics", "Organisational and student buy-in", "Perceived value and motivating factors", "Team coalition and support", and "Time and fit". Implementation of the programme was enhanced by resilient leaders managing the challenges of curricular change. Their belief in the value of the programme, stakeholder buy-in, and supportive team working enabled challenges to be overcome. Workload was reduced and student buy-in increased as time progressed and as more resources became available. A flexible approach to implementation was recommended to ensure the programme fits within the established curriculum.
Curricular change is a challenging task, yet necessary, if we are to improve care for people with long term conditions such as dementia. This study highlights the common barriers and facilitators experienced when implementing a longitudinal educational programme at scale. The findings presented in this study can be used by other educational institutions to manage curricular change efforts.
随着全球痴呆症患者数量的增加，医疗保健从业人员需要提高对该病症的认识和了解。有人担心，专注于短期护理的传统医疗教育模式会限制学生对长期病症的理解。因此，我们在英国的五所大学设计并开展了“痴呆症时刻”项目。通过与痴呆症患者家庭的长期接触，医学生对痴呆症患者的生活经历有了更多了解。然而，实施新的教育模式也带来了挑战。为了使其他教育机构能够实施类似项目，本研究旨在确定大规模实施这类纵向项目的常见障碍和促进因素。
为了解实施纵向痴呆症教育项目的促进因素和障碍，我们完成了一项定性研究。2018年10月至12月期间，对大学教学人员（n = 6）、项目管理人员（n = 4）和阿尔茨海默病协会工作人员（n = 2）进行了12次深入的半结构化访谈，他们对实施“痴呆症时刻”项目负有主要责任。访谈问题探讨了参与者的经历、促进因素以及实施该项目时遇到的挑战。访谈进行了录音，逐字转录，并采用归纳主题分析法进行分析。
分析确定了五个关键主题：“领导特征”、“组织和学生的认同”、“感知价值和激励因素”、“团队联盟和支持”以及“时间和适应性”。有韧性的领导者应对课程变革挑战，增强了项目的实施效果。他们对项目价值的信念、利益相关者的认同以及支持性的团队合作使得挑战得以克服。随着时间的推移和资源的增加，工作量减少，学生的认同度提高。建议采用灵活的实施方法，以确保该项目与既定课程相契合。
课程变革是一项具有挑战性但又必要的任务，如果我们要改善对痴呆症等长期病症患者的护理。本研究突出了大规模实施纵向教育项目时常见的障碍和促进因素。本研究的结果可供其他教育机构用于管理课程变革工作。
