Pallium Canada, Ottawa, Canada (Non-profit Foundation).
Division of Palliative Care, Department of Family Medicine, McMaster University, Hamilton, Canada.
Palliat Med. 2022 May;36(5):866-877. doi: 10.1177/02692163221081329. Epub 2022 Mar 8.
Palliative care educators should incorporate strategies that enhance application into practice by learners. Commitment-to-change is an approach to reinforce learning and encourage application into practice; immediately post-course learners commit to making changes in their practices as a result of participating in the course ("statements") and then several weeks or months later are prompted to reflect on their commitments ("reflections").
Explore if and how learners implemented into practice what they learned in a palliative care course, using commitment-to-change reflections.
Secondary analysis of post-course commitment statements and 4-months post-course commitment reflections submitted online by learners who participated in Pallium Canada's interprofessional, 2-day, Learning Essential Approaches to Palliative Care (LEAP) Core courses.
SETTING/PARTICIPANTS: Primary care providers from across Canada and different profession who attended LEAP Core courses from 1 April 2015 to 31 March 2017.
About 1063 of 4636 learners (22.9%) who participated in the 244 courses delivered during the study period submitted a total of 4250 reflections 4 months post-course. Of these commitments, 3081 (72.5%) were implemented. The most common implemented commitments related to initiating palliative care early across diseases, pain and symptom management, use of clinical instruments, advance care planning, and interprofessional collaboration. Impact extended to patients, services, and colleagues. Barriers to implementation into practice included lack of time, and system-level factors such as lack of support by managers and untrained colleagues.
Examples of benefits to patients, families, services, colleagues, and themselves were described as a result of participating in the courses.
姑息治疗教育者应将能够增强学习者应用能力的策略纳入实践。改变承诺是一种强化学习和鼓励将所学应用于实践的方法;课程结束后,学习者立即承诺在实践中做出改变(“承诺”),然后在数周或数月后,他们会被要求反思自己的承诺(“反思”)。
探讨学习者是否以及如何将姑息治疗课程中学到的知识应用于实践,使用改变承诺反思。
对参加 Pallium Canada 的跨专业 2 天学习基本姑息治疗方法(LEAP)核心课程的学习者在课程结束后提交的承诺声明和 4 个月后提交的承诺反思进行二次分析。
地点/参与者:来自加拿大各地和不同专业的初级保健提供者,他们参加了 LEAP 核心课程。
在研究期间,共有 4636 名学习者(22.9%)参加了 244 次课程,其中约有 1063 人在课程结束后 4 个月共提交了 4250 份反思。在这些承诺中,有 3081 项(72.5%)得到了执行。最常见的实施承诺涉及在各种疾病中尽早启动姑息治疗、疼痛和症状管理、使用临床工具、预先护理计划和跨专业合作。影响延伸到患者、服务和同事。实施实践的障碍包括缺乏时间以及系统层面的因素,如管理人员和未经培训的同事缺乏支持。
参加课程后,学习者描述了对患者、家庭、服务、同事和自己的益处。