Muralidhar Malvika, Delray Saskia, Cooper Claudia, Zabihi Sedigheh, Banerjee Sube, Giebel Clarissa, Dening Karen Harrison, Birks Yvonne, Kenten Charlotte, Walpert Madeleine
Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
Int J Geriatr Psychiatry. 2025 Jul;40(7):e70119. doi: 10.1002/gps.70119.
To systematically review research evidence on the effectiveness of dementia education and training for health and social care students.
We searched electronic databases for primary research studies (published between 2015 and 2024), evaluating dementia training for health and social care students. We assessed risk of bias using the Mixed Methods Appraisal Tool, prioritising studies scoring 4+ (higher quality) that reported significant findings on primary outcomes from controlled intervention trials. We reported outcomes using Kirkpatrick's framework. We consulted professional stakeholders in a focus group regarding how findings might inform practice.
17/35 included studies were rated 4+ on the MMAT; only one met our criteria for priority evidence. An experiential programme for medical students, 'Time for Dementia', which combined skill-learning and reflective sessions with visits to people with dementia, was found to improve Kirkpatrick Level 2 (learning) outcomes, attitudes and knowledge over 2 years of participation; this was supported from findings from qualitative studies. Asynchronous, self-directed learning did not improve learning outcomes, relative to standard training. Though almost all training programmes incorporated lived experience, no patient reported outcomes were used to evaluate the impact of training. Nine focus group attendees agreed that the evidence reflected their experiences that consistent support, combined with skills-based and reflective sessions, optimised student learning from initial patient-focused encounters.
Effective interventions increased confidence and enjoyment of dementia care encounters, and increased interest in careers in dementia specialities. Mandating evidence-based dementia skills programmes across specialities could ensure that students learn the skills and competencies required to be part of an effective future workforce and drive important improvements in care quality. Evidence based approaches to enhancing dementia education in training could include experiential learning modules in early years of medical school training and allied health and care professional training, using evidence-based approaches to teach communication skills and other essential dementia care skills within clinical placements, and providing dedicated supervision to support their implementation. Future research could usefully consider patient perspectives in determining the impact of educational programmes.
系统回顾关于痴呆症教育培训对健康与社会护理专业学生有效性的研究证据。
我们在电子数据库中检索了2015年至2024年间发表的关于评估健康与社会护理专业学生痴呆症培训的原始研究。我们使用混合方法评估工具评估偏倚风险，优先选择得分4分及以上（质量较高）的研究，这些研究报告了对照干预试验主要结局的显著结果。我们使用柯克帕特里克框架报告结局。我们在一个焦点小组中咨询了专业利益相关者，了解研究结果如何为实践提供信息。
纳入的35项研究中有17项在MMAT上被评为4分及以上；只有一项符合我们的优先证据标准。一项针对医学生的体验式项目“痴呆症时间”，将技能学习和反思课程与探访痴呆症患者相结合，发现在参与的两年中改善了柯克帕特里克二级（学习）结局、态度和知识；定性研究结果也支持了这一点。相对于标准培训，异步自主学习并未改善学习结局。尽管几乎所有培训项目都纳入了实际生活体验，但没有使用患者报告结局来评估培训的影响。九名焦点小组参与者一致认为，证据反映了他们的经验，即持续的支持，加上基于技能的课程和反思课程，优化了学生从最初以患者为中心的接触中的学习。
有效的干预措施提高了对痴呆症护理接触的信心和乐趣，并增加了对痴呆症专科职业的兴趣。在各专业中强制推行基于证据的痴呆症技能项目，可以确保学生学习成为有效未来劳动力所需的技能和能力，并推动护理质量的重要改善。在培训中加强痴呆症教育的循证方法可包括在医学院培训早期以及联合健康与护理专业培训中采用体验式学习模块，在临床实习中采用循证方法教授沟通技能和其他基本的痴呆症护理技能，并提供专门的监督以支持其实施。未来的研究可以在确定教育项目的影响时有益地考虑患者的观点。
