由模拟人物提供支持的培训,以促进预先护理计划中特定沟通技能的发展。

Training supported by simulated persons to promote the development of specific communication skills in advance care planning.

作者信息

Götze Kornelia, Otten-Marré Stefanie, Loupatatzis Barbara, In der Schmitten Jürgen

机构信息

University of Duisburg-Essen, Medical Faculty, Institute of Family Medicine & General Practice, Essen, Germany.

University Hospital Düsseldorf, Centre for Health and Society (chs), Institute of General Practice & General Practice, Düsseldorf, Germany.

出版信息

GMS J Med Educ. 2025 Feb 17;42(1):Doc11. doi: 10.3205/zma001735. eCollection 2025.

Abstract

OBJECTIVES

Advance care planning (ACP) has been conceived to ensure that patients who are unable to consent are treated in consistence with their well-informed, predetermined preferences. At an individual level, standardised conversations are offered by specifically qualified healthcare professionals (ACP facilitators). Internationally, there is considerable variability with regard to ACP qualifications. This article describes how ACP facilitators are trained in role plays employing simulated persons (SPs) in accordance with the standards of two professional societies.

METHODS

ACP experts developed ten roles in cooperation with an SP coach (director) based on real ACP conversations. The emotional and mental world of the role, ACP-relevant facts such as previous experience in the medical context, and aids for acting were developed, taking into account the central challenges in ACP conversations. To ensure standardisation, the SPs rehearsed in a structured manner and received feedback training. Microteaching techniques were developed for the facilitator training.

RESULTS

Feedback skills and openness towards the topics of serious illness, dying and death are required for the SP to be suitable. Since 2017, ACP facilitator training has taken place in small groups of four participants, one SP and one qualified ACP coach. The required framework is described in detail.

CONCLUSION

SP-supported training is a decisive improvement for the teaching and assessment of the highly complex ACP-facilitation skills and attitudes. Planning and implementation place high demands on SP and ACP coaches who also require specific qualifications.

摘要

目标

预先护理计划(ACP)旨在确保那些无法做出同意的患者能够按照其充分了解的、预先确定的偏好接受治疗。在个体层面,由具备特定资质的医疗保健专业人员(ACP促进者)进行标准化对话。在国际上,ACP资质方面存在很大差异。本文描述了如何根据两个专业协会的标准,通过使用模拟患者(SP)进行角色扮演来培训ACP促进者。

方法

ACP专家与一名SP教练(导演)合作,根据真实的ACP对话开发了十个角色。考虑到ACP对话中的核心挑战,构建了角色的情感和精神世界、与ACP相关的事实,如在医疗环境中的既往经历,以及表演辅助工具。为确保标准化,SP进行了结构化排练并接受了反馈训练。为促进者培训开发了微教学技术。

结果

要使SP合适,需要具备反馈技巧以及对重病、濒死和死亡等话题保持开放态度。自2017年以来,ACP促进者培训以小组形式进行,每组有四名参与者、一名SP和一名合格的ACP教练。详细描述了所需的框架。

结论

由SP支持的培训对于高度复杂的ACP促进技能和态度的教学与评估而言是一项决定性的改进。规划和实施对SP和ACP教练提出了很高的要求,他们也需要具备特定资质。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf15/12086250/887eea4323cb/JME-42-11-t-001.jpg

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