Section of Palliative Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.
Section of Hematology-Oncology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.
J Palliat Med. 2022 Nov;25(11):1708-1714. doi: 10.1089/jpm.2022.0247. Epub 2022 Aug 25.
Funding and limited resources are barriers to required training of residents in serious illness conversation (SIC) skills. To examine the effectiveness of a low-cost, low-resource (LCLR) SIC training embedded within a required palliative care rotation. Pre-post prospective cohort study design. Second year internal medicine (IM) residents received an LCLR three-hour training in the SIC Guide (SICG) with a single-faculty member and paired-participant practice replacing actors during a required two-week palliative medicine rotation. SIC competence checklist measured within simulated patient encounters longitudinally. Twenty resident average SIC checklist scores improved from 11 (95% confidence interval [CI] 9-13) at the beginning of rotation to 19 (95% CI 17-20) at the end of rotation and 18 (95% CI 16-20) at six months after the rotation. LCLR SIC training for IM residents significantly increased the sustained use of basic SIC skills, but was less effective for more complex skills.
资金和有限的资源是阻碍住院医师进行严重疾病对话（SIC）技能培训的障碍。为了检验一种低成本、低资源（LCLR）的 SIC 培训方法的有效性，该培训嵌入在强制性的姑息治疗轮转中。采用前后前瞻性队列研究设计。第二年的内科住院医师（IM）接受了 LCLR 三小时的 SIC 指南（SICG）培训，由一名教师和配对的参与者在强制性的为期两周的姑息医学轮转中代替演员进行实践。在模拟患者就诊中，通过 SIC 能力检查表进行纵向测量。在轮转开始时，20 名住院医师的 SIC 检查表平均得分为 11（95%置信区间[CI] 9-13），在轮转结束时提高到 19（95%CI 17-20），在轮转结束后六个月时提高到 18（95%CI 16-20）。对于 IM 住院医师来说，LCLR SIC 培训显著增加了基本 SIC 技能的持续使用，但对更复杂的技能效果较差。
