Palliative Care Curriculum for Medical Residents

住院医师姑息治疗课程

• 批准号: 7117426
• 负责人: CHARLES F VON GUNTEN
• 金额: $ 24.85万
• 依托单位: SAN DIEGO HOSPICE AND PALLIATIVE CARE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7117426
• 关键词: behavioral /social science research tag; clinical research; curriculum; education evaluation /planning; family medicine; health behavior; health care policy; health care quality; health care service evaluation; hospices; hospital patient care; medical education; patient care management; physicians; quality of life; terminal patient care

DESCRIPTION (provided by applicant): There is substantial evidence that physicians do not have adequate training in palliative care. In preliminary work, we have developed evaluation methods and curricula for physicians and established a hospice rotation for 65 residents training in three programs of internal medicine and two programs in family medicine each year. We hypothesize that a hospice rotation using a national curriculum for palliative care education for physicians will result in measurable improvements in knowledge, attitudes and skills. The primary endpoint for study is the scores on a validated 36-item question of knowledge for which a national reference database exists. Secondary endpoints are self-rated scores of confidence and competence in palliative care. We will test this hypothesis applying the same curriculum to 65 resident three from five different training programs each year for five years. Programs will administer the evaluation instruments to their residents within the first month of the PGY-1 year. Residents will be required to complete four modules of the EPEC Curriculum, a national curriculum covering the core competencies of palliative care for physicians using the internet for self-study. Faculty will help the student apply the attitudes, knowledge and skills during clinical exposure to patients in the inpatient and home hospice settings. Residents will demonstrate communication skills with a standardized patient. The instruments will be readministered during the last two months of residency training. Psychometrically equivalent knowledge examinations will be used to prevent recall of items on repeated examination. We will analyze the data using the One-Group Time Series Design. The package of three evaluation instruments will be administered at four time periods during the three years of residency training- Pre 1 (beginning of residency); Pre 2 (beginning of rotation); Post 1 (completion of rotation); Post 2 (completion of residency). The One Group Time Series Design permits us to evaluate questions that are on the minds of all residency program directors as they seek to incorporate a palliative care curriculum within the three-year training period: 1) What effect does the curriculum have if it is required versus elective? 2) How long does the rotation need to be? In other words, what is the effect of time on task? 3) When should the rotation be placed in a 3-year residency, in the beginning or the end? 4) Are there differences between internal medicine and family practice residents who are exposed to this curriculum? 5) Does the type of training program (university hospital versus community teaching hospital versus military hospital) have any effect on the retention of information? and 6) Is there evidence of yearly interaction among these various factors?

描述（由申请人提供）：有大量证据表明，医生在姑息治疗中没有足够的培训。 在初步工作中，我们为医师开发了评估方法和课程，并为每年的三个内科计划和两个家庭医学计划中的65名居民培训建立了临终关怀轮换。 我们假设使用国家课程为医生进行姑息治疗教育的临终关怀轮换将导致知识，态度和技能的可衡量改善。 研究的主要终点是对国家参考数据库存在的经过验证的36项知识问题的分数。 次要终点是姑息治疗中自信和能力的自我评价得分。 我们将在五年内每年从五个不同的培训计划中使用相同的课程对65个居民进行相同的课程进行检验。 计划将在PGY-1年的第一个月内向其居民管理评估工具。 居民将被要求完成四个EPEC课程的模块，这是一项全国性课程，涵盖了使用互联网进行自学的医生的姑息治疗的核心能力。 教师将帮助学生在住院和家庭临终关怀环境中对患者的临床暴露期间的态度，知识和技能运用。 居民将与标准化患者展示沟通技巧。 在居住培训的最后两个月中，这些仪器将被重新任命。 在心理上等效的知识检查将用于防止在反复检查中回忆项目。 我们将使用一组时间序列设计分析数据。 三种评估工具的包装将在居住培训的三年培训前四个时期（居住开始）进行管理；前2（旋转开始）；帖子1（旋转完成）；帖子2（居留完成）。 一个小组时间序列设计使我们能够评估所有居住计划董事想在三年培训期内合并姑息治疗课程时，他们会在所有居住计划主管的心中评估问题：1）课程是否需要与选择性相比，该课程会产生什么影响？ 2）旋转需要多长时间？ 换句话说，时间对任务的影响是什么？ 3）何时应将旋转放置在一开始或结束时居住3年？ 4）内科和家庭实践居民之间接触此课程的居民是否存在差异？ 5）培训计划的类型（大学医院与社区教学医院与军事医院）是否对保留信息有任何影响？ 6）是否有证据表明这些因素之间每年相互作用？