Gill Ashlinder, Romeril Sarah, Meadows Lynn, Flanagan Alison, Rhayel Ashwak, Panza Michael, Klinger Christopher, Duboff Narisa, Pereira Jose, Bellaire Joan
Division of Palliative Care, Department of Family Medicine, McMaster University, Hamilton, Canada.
School of Nursing, McMaster University, Hamilton, Canada.
Palliat Med Rep. 2025 May 5;6(1):205-214. doi: 10.1089/pmr.2024.0094. eCollection 2025.
In Canada, access to palliative care varies across jurisdictions. Many health care professionals lack core palliative care competencies. To help build capacities, a pilot education program was conducted at a community hospital in Southwestern Ontario (Canada). Using Pallium Canada's Learning Essential Approaches to Palliative Care (LEAP) Hospital course, generalist hospital physicians participated in this initiative. The purpose of this investigation was to explore the impact of the LEAP Hospital course on physician attitudes, comfort, and care delivery.
Within a Plan-Do-Study-Act framework, a mixed-methods design summarized post-course evaluations, commitment to change (CTC) statements, and interviews with learners and hospital staff. Participants completed pre-course knowledge and post-participation surveys. Group and individual interviews were conducted with learners and staff who practiced alongside LEAP learners. Descriptive statistics were completed for aggregate survey data. Thematic analysis was conducted to summarize learner and staff experiences.
Twenty-nine physicians completed the LEAP Hospital course. Ninety-six CTC statements identified improvements in symptom management and communication. Sixteen participants participated in interviews. Learners and hospital staff noted the impact courses had on symptom and disease management and enhanced communication when discussing goals of care. Learners valued case-based learning and connecting with peers who are often siloed in practice. Participants also noted the inclusion of allied health for greater collaboration.
LEAP Hospital courses enhanced knowledge and skills and incorporated a greater palliative approach to care. Establishing a community of practice to address educational needs and strategies should be considered while supporting the inclusion of new graduates and hires.
在加拿大，姑息治疗的可及性因司法管辖区而异。许多医疗保健专业人员缺乏核心姑息治疗能力。为了帮助提高能力，在加拿大安大略省西南部的一家社区医院开展了一项试点教育项目。通才医院医生使用加拿大姑息治疗协会的姑息治疗学习基本方法（LEAP）医院课程参与了该项目。本调查的目的是探讨LEAP医院课程对医生态度、舒适度和护理提供的影响。
在计划-执行-研究-行动框架内，采用混合方法设计总结课程后的评估、变革承诺（CTC）陈述以及对学习者和医院工作人员的访谈。参与者完成了课程前的知识和参与后的调查。对与LEAP学习者一起实践过的学习者和工作人员进行了小组和个人访谈。对汇总的调查数据进行了描述性统计。进行了主题分析以总结学习者和工作人员的经历。
29名医生完成了LEAP医院课程。96条CTC陈述指出在症状管理和沟通方面有改进。16名参与者参加了访谈。学习者和医院工作人员指出，课程对症状和疾病管理有影响，并在讨论护理目标时加强了沟通。学习者重视基于案例的学习以及与在实践中往往孤立工作的同行建立联系。参与者还指出纳入了联合健康专业人员以加强协作。
LEAP医院课程增强了知识和技能，并纳入了更全面的姑息治疗方法。在支持新毕业生和新员工融入的同时，应考虑建立一个实践社区来满足教育需求和制定策略。
