Department of Social and Behavioral Sciences College of Public Health, Temple University, Philadelphia, PA, USA.
Gift of Life Donor Program, Philadelphia, PA, USA.
BMC Med Educ. 2024 Jan 22;24(1):77. doi: 10.1186/s12909-024-05026-9.
Approaching families of dying or newly deceased patients to donate organs requires specialized knowledge and a mastery of relational communication. As the transplantation field has progressed, Donation Professionals (DPs) are also leading conversations with family decision makers (FDMs) about the donation of uncommon anatomical gifts, such as face, hands, genitalia, referred to as Vascularized Composite Allotransplants (VCA) without much training or experience. To address the need for training, we adapted and beta tested an evidenced-based communication training program for donation discussions to VCA requests. The overarching goal of Communicating Effectively about Donation for Vascularized Composite Allotransplantation (CEaD-VCA) is to increase the number of VCA authorizations and to improve the socioemotional outcomes of FDMs.
We developed CEaD-VCA, an online, on-demand training program based on the previously tested, evidenced-based communication skills training program designed to train DPs to have conversations about solid organ donation. The training was modified utilizing data from a national telephone survey with DPs and results of 6 focus groups conducted with members of the general public. The survey and focus groups assessed knowledge, attitudes, and barriers to VCA donation. The training was shaped by a partnership with a leading industry partner, the Gift of Life Institute.™ RESULTS: Using the results as a guide, the existing CEaD training program, consisting of interactive eLearning modules, was adapted to include technical information about VCA, foundational communication skills, and two interactive example VCA donation request scenarios to facilitate active learning. Forty-two DPs from two partner Organ Procurement Organizations (OPOs) participated in the beta test of CEaD-VCA. Pre- and post-test surveys assessed the impact of the training.
The training was scored highly by DPs in effectiveness and ease of use. This project created a standardized, accessible, and comprehensive training for DPs to communicate about VCA donation. CEaD-VCA is an example of how to develop a communication skills training for difficult conversations utilizing input from stakeholders, guided by communication theory. It also demonstrates how gaps in communication skills during medical education can be filled utilizing advanced online Learning Management Systems. The training specifically addresses new CMS rules concerning OPO performance metrics.
接近临终或新近去世患者的家属，要求捐献器官，这需要专业知识和关系沟通技巧。随着移植领域的发展，捐赠专业人员（DPs）也在与家属决策者（FDMs）就不常见的解剖学礼物的捐献进行对话，例如面部、手部、生殖器，这些被称为血管化复合移植（VCA），他们并没有接受太多的培训或经验。为了解决培训需求，我们改编并测试了一个基于循证的沟通培训计划，用于 VCA 请求的捐赠讨论。有效沟通促进血管化复合移植捐赠（CEaD-VCA）的总体目标是增加 VCA 授权数量，并改善 FDMs 的社会情感结果。
我们开发了 CEaD-VCA，这是一个在线按需培训计划，基于之前经过测试的循证沟通技巧培训计划，旨在培训 DPs 进行关于实体器官捐献的对话。该培训利用来自全国 DP 电话调查的数据和与普通公众进行的 6 个焦点小组的结果进行了修改。该调查和焦点小组评估了 VCA 捐赠的知识、态度和障碍。培训由与领先的行业合作伙伴Gift of Life Institute（TM）的合作指导。结果：使用调查结果作为指导，现有的 CEaD 培训计划，包括互动电子学习模块，经过改编，包括 VCA 的技术信息、基础沟通技巧以及两个互动的 VCA 捐赠请求场景，以促进主动学习。来自两个器官获取组织（OPO）的 42 名 DP 参加了 CEaD-VCA 的测试。前后测试调查评估了培训的影响。
DPs 对培训的有效性和易用性评价很高。该项目为 DPs 提供了一种标准化、可访问且全面的培训，以就 VCA 捐赠进行沟通。CEaD-VCA 是一个利用利益相关者的投入、以沟通理论为指导，为困难对话开发沟通技巧培训的范例。它还展示了如何利用先进的在线学习管理系统来填补医学教育中沟通技巧的差距。该培训特别针对 CMS 关于 OPO 绩效指标的新规定。
