Faculty of Nursing, University of Calgary, Calgary, Canada.
Cumming School of Medicine, University of Calgary, Calgary, Canada.
BMC Med Educ. 2024 Jun 21;24(1):686. doi: 10.1186/s12909-024-05663-0.
Compassion is positively associated with improved patient outcomes, quality care ratings, and healthcare provider wellbeing. Supporting and cultivating healthcare providers' compassion through robust and meaningful educational initiatives has been impeded by a lack of conceptual clarity, inadequate content coverage across the domains of compassion, and the lack of validated evaluation tools. The EnACT program aims to address these gaps through an Evidence-informed, competency-based, Applied, Compassion Training program delivered to healthcare providers working in various clinical settings. In this study, we describe the development and initial validation of the program, which will inform and be further evaluated in a forthcoming Randomised Controlled feasibility Trial (RCfT).
A multimethod design was used to explore learner needs, experiences, and outcomes associated with the program. Pre- and post-training surveys and qualitative interviews (1 month post training) were conducted among twenty-six healthcare provider learners working in acute care and hospice. Quantitative measures assessed professional fulfillment/burnout, self-confidence in providing compassion, learner satisfaction, and compassion competence. Qualitative interviews explored learners' experiences of the program, integration of learnings into their professional practice, and program recommendations.
Learners exhibited relatively high self-assessed compassion competence and professional fulfillment pre-training and low levels of burnout. Post-training, learners demonstrated high levels of compassion confidence and satisfaction with the training program. Despite high levels of reported compassion competence pre-training, a statistically significant increase in post-training compassion competence was noted. Thematic analysis identified five key themes associated with learners' overall experience of the training day and integration of the learnings and resources into their professional practice: (1) A beginner's mind: Learner baseline attitudes and assumptions about the necessity and feasibility of compassion training; (2) Learners' experiences of the training program; (3) Learner outcomes: integrating theory into practice; (4) Creating cultures of compassion; and (5) Learner feedback.
Findings suggest that the EnACT program is a feasible, rigorous, and effective training program for enhancing healthcare provider compassion. Its evidence-based, patient-informed, clinically relevant content; interactive in class exercises; learner toolkit; along with its contextualized approach aimed at improving the clinical culture learners practice holds promise for sustaining learnings and clinical impact over time-which will be further evaluated in a Randomized Controlled feasibility Trial (RCfT).
同情心与改善患者预后、高质量护理评分和医疗保健提供者幸福感呈正相关。通过强有力的、有意义的教育举措来支持和培养医疗保健提供者的同情心,这一直受到概念不清晰、同情心领域内容覆盖不足以及缺乏经过验证的评估工具的阻碍。EnACT 计划旨在通过向在各种临床环境中工作的医疗保健提供者提供基于证据的、基于能力的、应用的、同情心培训计划来解决这些差距。在本研究中,我们描述了该计划的开发和初步验证,这将为即将进行的随机对照可行性试验 (RCfT) 提供信息,并进一步进行评估。
采用多方法设计来探讨学习者与该计划相关的需求、经验和结果。在 26 名从事急性护理和临终关怀的医疗保健提供者学习者中进行了培训前和培训后调查以及定性访谈(培训后 1 个月)。定量测量评估了专业满意度/倦怠、提供同情心的自信、学习者满意度和同情心能力。定性访谈探讨了学习者对该计划的体验、将所学知识融入专业实践以及对该计划的建议。
学习者在培训前表现出相对较高的自我评估的同情心能力和专业满意度,以及较低的倦怠水平。培训后,学习者表现出较高的同情心信心和对培训计划的满意度。尽管培训前报告的同情心能力较高,但培训后同情心能力的显著增加是显著的。主题分析确定了五个与学习者对培训日的整体体验以及将所学知识和资源融入其专业实践相关的关键主题:(1)初学者心态:学习者对同情心培训的必要性和可行性的基线态度和假设;(2)学习者对培训计划的体验;(3)学习者的结果:将理论融入实践;(4)创造同情心文化;(5)学习者的反馈。
研究结果表明,EnACT 计划是一种可行的、严格的、有效的医疗保健提供者同情心增强培训计划。其基于证据、以患者为中心、具有临床相关性的内容;课堂互动练习;学习者工具包;以及其旨在改善学习者实践的临床文化的情境化方法有望随着时间的推移维持学习和临床影响-这将在一项随机对照可行性试验 (RCfT) 中进一步评估。