Department of Ethics, Law and Humanities, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
Department of Public and Occupational Health, Expertise Center for Palliative Care, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
BMC Palliat Care. 2023 Oct 21;22(1):158. doi: 10.1186/s12904-023-01284-4.
Healthcare professionals in palliative care are found to be confronted with moral challenges on a frequent basis. CURA is a low-threshold instrument for dialogical ethical reflection that was developed to deal with these challenges. A previous study identified the need of healthcare professionals to be trained to introduce CURA in their organization, initiate and facilitate reflections with CURA, and contribute to the implementation of CURA. The aim of this study was to develop and evaluate a training for professionals to become 'CURA-ambassadors'.
The training was developed in a participatory way in two cycles. We trained 72 healthcare professionals. The training was evaluated by means of a questionnaire and six semi-structured interviews.
The study resulted in a blended learning training combining training sessions with an e-module and with practicing with organizing and facilitating CURA in daily healthcare practice. The main objectives of the training are to enable CURA-ambassadors to introduce CURA within their organization, initiate and facilitate ethical reflections using CURA, and contribute to the implementation of CURA. Participants were generally positive about the training program and the trainers. Technical difficulties related to the e-module were mentioned as main point of improvement.
The training program can generate ownership, responsibility, and competency among CURA-ambassadors, which are essential foundations for implementing complex interventions in healthcare practice. The training program received positive evaluations shortly after completing the program. This study adds to our understanding of what is needed for healthcare professionals to use CURA, in order to support them in dealing with moral challenges and to foster their moral resilience. Further research is needed to assess whether participants experience the training as sufficient and effective when using and implementing CURA structurally in their organizations over a longer period of time.
姑息治疗中的医疗保健专业人员经常面临道德挑战。CURA 是一种用于对话伦理反思的低门槛工具，旨在应对这些挑战。先前的研究表明，医疗保健专业人员需要接受培训，以便在其组织中引入 CURA，用 CURA 发起和促进反思，并为 CURA 的实施做出贡献。本研究旨在开发和评估一种培训，以培养“CURA 大使”。
该培训以参与式的方式在两个周期内进行。我们培训了 72 名医疗保健专业人员。通过问卷调查和六次半结构化访谈评估培训。
该研究产生了一种混合学习培训，将培训课程与电子模块相结合，并在日常医疗实践中组织和促进 CURA 的实践相结合。培训的主要目标是使 CURA 大使能够在其组织中引入 CURA，使用 CURA 发起和促进伦理反思，并为 CURA 的实施做出贡献。参与者对培训计划和培训师普遍持积极态度。提到电子模块的技术困难是主要的改进点。
培训计划可以在 CURA 大使中产生所有权、责任和能力，这是在医疗保健实践中实施复杂干预的必要基础。培训计划在完成后不久就获得了积极评价。本研究增加了我们对医疗保健专业人员使用 CURA 所需的理解，以支持他们应对道德挑战并培养他们的道德韧性。需要进一步研究，以评估参与者在更长时间内将 CURA 结构地用于其组织中时，是否认为培训是充分和有效的。
