Department of Medicine, Division of Pulmonary and Clinical Care Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Emergency Medicine, China Medical University, Shenyang, China.
BMC Med Educ. 2022 Jul 13;22(1):540. doi: 10.1186/s12909-022-03605-2.
The current global pandemic has caused unprecedented strain on critical care resources, creating an urgency for global critical care education programs. Learning needs assessment is a core element of designing effective, targeted educational interventions. In theory, multimodal methods are preferred to assess both perceived and unperceived learning needs in diverse, interprofessional groups, but a robust design has rarely been reported. Little is known about the best approach to determine the learning needs of international critical care professionals.
We conducted multimodal learning needs assessment in a pilot group of critical care professionals in China using combined quantitative and qualitative methods. The assessments consisted of three phases: 1) Twenty statements describing essential entrustable professional activities (EPAs) were generated by a panel of critical care education experts using a Delphi method. 2) Eleven Chinese critical care professionals participating in a planned education program were asked to rank-order the statements according to their perceived learning priority using Q methodology. By-person factor analysis was used to study the typology of the opinions, and post-ranking focus group interviews were employed to qualitatively explore participants' reasoning of their rankings. 3) To identify additional unperceived learning needs, daily practice habits were audited using information from medical and nursing records for 3 months.
Factor analysis of the rank-ordered statements revealed three learning need patterns with consensual and divergent opinions. All participants expressed significant interest in further education on organ support and disease management, moderate interest in quality improvement topics, and relatively low interest in communication skills. Interest in learning procedure/resuscitation skills varied. The chart audit revealed suboptimal adherence to several evidence-based practices and under-perceived practice gaps in patient-centered communication, daily assessment of antimicrobial therapy discontinuation, spontaneous breathing trial, and device discontinuation.
We described an effective mixed-methods assessment to determine the learning needs of an international, interprofessional critical care team. The Q survey and focus group interviews prioritized and categorized perceived learning needs. The chart audit identified additional practice gaps that were not identified by the learners. Multimodal methods can be employed in cross-cultural scenarios to customize and better target medical education curricula.
当前的全球大流行给重症监护资源带来了前所未有的压力,这就迫切需要开展全球重症监护教育计划。学习需求评估是设计有效、有针对性的教育干预措施的核心要素。从理论上讲,多模式方法更适合评估多元化、跨专业群体中感知到的和未感知到的学习需求,但很少有研究报告稳健的设计。对于如何确定国际重症监护专业人员的学习需求,我们知之甚少。
我们采用结合定量和定性方法,在中国的一组重症监护专业人员中进行了多模式学习需求评估。评估包括三个阶段:1)一组重症监护教育专家使用德尔菲法生成 20 项描述基本可委托专业活动(EPAs)的陈述。2)11 名参与计划中的教育项目的中国重症监护专业人员使用 Q 分类法根据他们认为的学习优先级对陈述进行排序。通过个体因素分析研究意见的类型学,并在排序后进行焦点小组访谈,从定性角度探讨参与者对其排名的推理。3)为了确定额外的未感知到的学习需求,使用医疗和护理记录中的信息对 3 个月的日常实践习惯进行审核。
对排序陈述的因子分析揭示了三种具有一致和分歧意见的学习需求模式。所有参与者都对器官支持和疾病管理方面的进一步教育表示出浓厚的兴趣,对质量改进主题表示出中等程度的兴趣,对沟通技巧表示出相对较低的兴趣。对学习程序/复苏技能的兴趣各不相同。图表审核显示,在以患者为中心的沟通、每日评估抗菌药物停药、自主呼吸试验和器械停用方面,有几个证据基础实践的执行情况不佳,实践差距的感知不足。
我们描述了一种有效的混合方法评估,以确定一个国际、跨专业的重症监护团队的学习需求。Q 调查和焦点小组访谈优先考虑和分类感知到的学习需求。图表审核确定了学习者未识别的其他实践差距。多模式方法可用于跨文化情境,以定制和更好地针对医学教育课程。