Institute for Medical Education, University of Bern, Mittelstrasse 43, Bern, 3012, Switzerland.
Department of Anesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
BMC Med Educ. 2024 Oct 25;24(1):1212. doi: 10.1186/s12909-024-06142-2.
Integrating spiritual aspects into treatment plans can release essential resources for coping with chronic pain. However, some spiritual aspects may also induce distress and hinder the coping process. There is a lack of evidence regarding how to perform the clinical tasks of exploring spiritual aspects and of instruments assessing related competencies. Therefore, we developed a web-based learning module to provide education on the subject alongside corresponding assessment instruments. The module presents the InSpiRe (Integration of Spirituality and/or Religion in patient encounters) protocol. The instruments encompass cognitive, affective, and behavioral dimensions.
This paper aims to determine (i) the learning effects associated with completing the web-based spiritual-care learning module and (ii) the reliability and validity of the instruments employed. To address these aims, we conducted a pre-test/post-test trial with N = 32 randomly selected fourth-year medical students. During the pre-test, we assessed the students' knowledge, attitudes, and self-efficacy regarding exploring spiritual aspects. For this purpose, we developed a short-answer knowledge test, an attitude questionnaire, and a self-efficacy scale. Additionally, the students explored spiritual aspects with a simulated patient portraying a person with chronic pain. Three trained raters evaluated the students' performances using a self-developed scale. In the intervention phase, the students completed the 45-minute learning module on a personal computer. The module presented InSpiRe-related content as text and step-by-step video demonstrations, including hints that denote critical actions. The subsequent post-test was identical to the pre-test.
The internal consistency was suitable for all respective instruments, and there was an indication of solid validity of the performance test. After completing the spiritual care learning module, the students showed statistically significant increases in knowledge scores and significant positive shifts in their attitudes and levels of self-efficacy regarding exploring spiritual aspects. They also attained significantly higher performance scores in the same regard.
Completing the spiritual-care module is associated with meaningful learning effects on cognitive, affective, and behavioral dimensions related to exploring spiritual aspects, as demonstrated in the post-test conducted shortly after the intervention. Due to good reliability and validity scores, the self-developed instruments can be applied appropriately.
将精神层面融入治疗方案可以为应对慢性疼痛释放重要资源。然而，一些精神层面也可能引发痛苦并阻碍应对过程。目前缺乏关于如何开展探索精神层面的临床任务以及评估相关能力的工具的证据。因此，我们开发了一个基于网络的学习模块，提供相关教育以及评估工具。该模块介绍了 InSpiRe（将精神/宗教融入医患互动）方案。这些工具涵盖认知、情感和行为维度。
本文旨在确定（i）完成基于网络的精神关怀学习模块所带来的学习效果，以及（ii）所使用工具的信度和效度。为了达到这些目的，我们对 32 名随机选择的四年级医学生进行了预测试/后测试试验。在预测试中，我们评估了学生在探索精神层面方面的知识、态度和自我效能感。为此，我们开发了一个简答题知识测试、一个态度问卷和一个自我效能量表。此外，学生通过模拟患者来探索精神层面，该患者患有慢性疼痛。三名经过培训的评估员使用自行开发的量表对学生的表现进行评估。在干预阶段，学生在个人电脑上完成了 45 分钟的学习模块。该模块以文本和分步视频演示的形式呈现了 InSpiRe 相关内容，包括表示关键操作的提示。随后的后测与预测试相同。
所有相关工具的内部一致性都合适，并且绩效测试具有明显的有效性。完成精神关怀学习模块后，学生在知识测试中得分显著提高，对探索精神层面的态度和自我效能感显著转变，且在同样方面的表现得分显著提高。
在干预后不久进行的后测中，完成精神关怀模块与在探索精神层面的认知、情感和行为维度上的有意义的学习效果相关联。由于可靠性和有效性得分良好，因此可以适当应用自行开发的工具。
