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课程研究:通过适应性课程传播神经姑息治疗教育:一项多中心可行性试验

Curriculum Research: Disseminating Neuropalliative Care Education Through an Adaptable Curriculum: A Multisite Feasibility Trial.

作者信息

Harrigan Eileen, Taylor Breana L, Kirsch Hannah L, Ghoshal Shivani, Kwei Kimberly T, Brizzi Kate T, Creutzfeldt Claire J, Goyal Tarini

机构信息

From the Division of Geriatric Medicine and Palliative Care (E.H.), Department of Medicine, NYU Langone Health, New York; Department of Neurology (B.L.T., C.J.C.), University of Washington, Seattle; Department of Neurology & Neurological Sciences (H.L.K.), Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (S.G., K.T.K., T.G.), New York Presbyterian-Columbia University Irving Medical Center, NY; Division of Palliative Care (K.T.B.), Departments of Neurology and Medicine, Massachusetts General Hospital, Boston; and Cambia Palliative Care Center of Excellence (C.J.C.), University of Washington, Seattle.

出版信息

Neurol Educ. 2024 May 21;3(2):e200133. doi: 10.1212/NE9.0000000000200133. eCollection 2024 Jun.

Abstract

INTRODUCTION AND PROBLEM STATEMENT

Neurologic disease is a leading cause of disability and death worldwide. As the global population ages, the burden of these diseases is expected to increase. Despite this increased clinical need, neurology trainees are seldom taught skills and concepts in palliative care. Education in Palliative and End-of-Life Care for Neurology (EPEC-N) is a publicly available neuropalliative care curriculum designed to be taught by both palliative care specialists and nonspecialists alike.

OBJECTIVES

(1) To create a feasible curriculum in neuropalliative care using EPEC-N, (2) to improve learners' satisfaction with neuropalliative care training, and (3) to improve learners' confidence with neuropalliative care topics.

METHODS AND CURRICULUM DESCRIPTION

Three academic centers implemented a neuropalliative care curriculum for neurology residents using EPEC-N modules. Each site selected 4 of the 26 topics. Instructor backgrounds varied by site and included neurology senior residents, fellows, and faculty; none had completed palliative care fellowship at the time of teaching. Teaching methods included lecture, case discussion, and role-play. To assess feasibility and acceptability of this curriculum, learners, instructors, and site leads completed postsession surveys.

RESULTS AND ASSESSMENT DATA

A total of 87 residents attended at least 1 didactic session, and 23 residents completed the evaluation survey. All 3 sites were able to successfully implement an evidence-based and subspecialist-approved neuropalliative care curriculum without relying on subspecialty instruction, despite variations in instructor background, curriculum format, and module selection. Learners overall expressed a positive experience with this curriculum, with most of the respondents indicating that each session was effective in improving their knowledge base, relevant to current practice, and provided in an effective teaching format. Site leads and instructors found the curriculum easy to use, in minimal need of modification, and helpful for delivering neuropalliative care education.

DISCUSSION AND LESSONS LEARNED

The EPEC-N curriculum was successfully implemented at 3 US sites, demonstrating feasibility, acceptability, and adaptability across institutions. Further research is needed to evaluate the effectiveness of this curriculum in improving neuropalliative care skills for neurologists and raising the standard of primary neuropalliative care.

摘要

引言与问题陈述

神经系统疾病是全球致残和致死的主要原因。随着全球人口老龄化,这些疾病的负担预计将会增加。尽管临床需求不断增加,但神经科住院医师很少接受姑息治疗方面的技能和概念培训。神经科姑息与临终关怀教育(EPEC-N)是一门公开可用的神经姑息治疗课程,旨在由姑息治疗专家和非专家共同授课。

目标

(1)使用EPEC-N创建一门可行的神经姑息治疗课程,(2)提高学习者对神经姑息治疗培训的满意度,(3)增强学习者对神经姑息治疗主题的信心。

方法与课程描述

三个学术中心为神经科住院医师实施了一门使用EPEC-N模块的神经姑息治疗课程。每个站点从26个主题中选择了4个。各站点的教师背景各不相同,包括神经科高年级住院医师、研究员和教员;在教学时他们都没有完成姑息治疗进修。教学方法包括讲座、病例讨论和角色扮演。为了评估该课程的可行性和可接受性,学习者、教师和站点负责人在课程结束后完成了调查问卷。

结果与评估数据

共有87名住院医师参加了至少一次理论课程,23名住院医师完成了评估调查。尽管教师背景、课程形式和模块选择存在差异,但所有3个站点都能够在不依赖专科指导的情况下成功实施一门基于证据且经专科认可的神经姑息治疗课程。总体而言,学习者对该课程的体验良好,大多数受访者表示每次课程都有效地提高了他们的知识基础,与当前实践相关,并且教学形式有效。站点负责人和教师认为该课程易于使用,几乎无需修改,并且有助于开展神经姑息治疗教育。

讨论与经验教训

EPEC-N课程在美国的3个站点成功实施,证明了其在不同机构中的可行性、可接受性和适应性。需要进一步的研究来评估该课程在提高神经科医生的神经姑息治疗技能以及提升初级神经姑息治疗水平方面的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37ea/11441752/a889785d728c/NXE-2023-000187f1.jpg

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本文引用的文献

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Neuropalliative care: Priorities to move the field forward.神经舒缓照护:推动该领域发展的优先事项。
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