Hospice Educational Program for the School of Medicine

医学院临终关怀教育计划

• 批准号: 8107570
• 负责人: DOUGLAS DONALD ROSS
• 金额: $ 24.26万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-30 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8107570
• 关键词: Accreditation; Achievement; Address; Area; Cancer Center; Cancer Education Grant Program; Caring; Chairperson; Clinical; Competence; Consensus; Development; Education; Educational Curriculum; Educational process of instructing; Effectiveness; Evaluation; Faculty; Fellowship; Foundations; Funding; Goals; Grant; Health Professional; Hematology; Hospice Care; Hour; Incentives; Individual; Institutionalization; Internal Medicine; Knowledge; Lead; Learning; Letters; Maryland; Measures; Medical; Medical Education; Medical Oncology; Medical Students; Medicine; National Cancer Institute; Nursing Faculty; Online Systems; Outcome; Palliative Care; Patient Care; Performance; Personal Communication; Physicians; Program Evaluation; Programmed Learning; Research Personnel; Residencies; Rotation; Specific qualifier value; Students; Supervision; System; Time; Trainers Training; Training; Training Programs; Universities; Wages; authority; base; clinical practice; design; end of life; experience; frontier; graduate medical education; graduate student; hospice environment; instructor; knowledge base; medical schools; meetings; member; neglect; novel; oncology; palliative; pre-clinical; programs; response; skills; tool

DESCRIPTION (provided by applicant): This application seeks the competitive renewal of an R25 grant-funded project whose long-term goals are to develop, implement, evaluate and institutionalize comprehensive training programs in palliative and end-of-life care at the University of Maryland School of Medicine. During the last funding period, we focused on internal medicine residents, where our goal was to develop, evaluate, and institutionalize required training in palliative and end-of-life care for these learners. Since our residents come from many different medical schools and do not have homogeneous grounding in palliative care, a major thrust during the last funding period was to provide them with a uniform knowledge base in palliative care. This was accomplished by the design, implementation, and evaluation of a comprehensive, Web-based palliative care training program for our medicine residents. Program evaluation revealed that the Web-based palliative care training is feasible, and the residents found it to be of value in their clinical practice. Hence, we have achieved the fundamental goals of the last funding period. However, a knowledge base alone does not assure competence in clinical practice. Competency- based training through direct clinical experience with outcomes-based performance assessed by proficient clinical faculty is needed to assure that our graduate medical learners are competent in palliative care. Hence, for the next funding period, our strategy is to construct a clinical experiential palliative care learning program for medicine residents and medical oncology fellows that will build on the knowledge base provided by the Web-based learning program. This will be accomplished by requiring the residents and fellows to demonstrate competence in essential palliative care domains to their attending physician during clinical rotations. Evaluation of learner proficiency will be done within the framework of the six core competencies for residency education specified by the Accreditation Council for Graduate Medical Education (ACGME) "Outcomes Project." By requiring the residents and fellows to obtain an evaluation of their competency in multiple palliative care domains, our clinical faculty will in turn be requested to make these specific competency evaluations. This provides us with a novel incentive for faculty to learn palliative care content. Hence, we believe that the time is ripe to focus on what may be the "final frontier" in graduating medical residents with competence in palliative care, namely, end-of-life care education for key clinical faculty members. To accomplish this, we formulated the following specific aims: Aim 1: To create specific tools for use by clinical faculty members to evaluate delivery of quality end-of-life and palliative care by medical residents or oncology fellows under their supervision during clinical rotations, using the six competency areas set forth by the ACGME. Aim 2: To educate our internal medicine and medical oncology faculty in content related to palliative and end-of-life care to enable them to use the evaluation tools created in Aim 1 to assess the competency of medical residents and oncology fellows under their supervision in the delivery of quality palliative and end-of-life care during clinical rotations. Aim 3: To apply outcome-based measures to evaluate the effectiveness of the competency-based educational program to determine whether our internal medicine residents and medical oncology fellows follow good palliative and end-of-life care practices.

描述（由申请人提供）：本申请寻求R25赠款资助的项目的竞争续约，该项目的长期目标是在马里兰大学医学院的姑息治疗和临终关怀中开发，实施，评估和制度化全面的培训计划。在最后一个资金期间，我们专注于内科居民，我们的目标是为这些学习者开发，评估和制度化所需的姑息治疗和临终护理培训。由于我们的居民来自许多不同的医学院，并且在姑息治疗中没有均匀的基础，因此在最后一个资金期间，主要推力是为他们提供姑息治疗中统一的知识库。这是通过针对我们的医学居民的全面，基于网络的姑息治疗培训计划的设计，实施和评估来完成的。计划评估表明，基于网络的姑息治疗培训是可行的，居民发现它在其临床实践中具有价值。因此，我们已经实现了最后一个资金时期的基本目标。但是，仅一个知识库并不能确保在临床实践中的能力。需要通过直接临床经验进行基于能力的培训，并通过熟练的临床教师评估基于结果的绩效，以确保我们的研究生医学学习者在姑息治疗方面都有能力。因此，在下一个资金期间，我们的策略是为医学居民和医学肿瘤学研究员建立一个临床体验姑息治疗学习计划，该计划将基于基于Web的学习计划提供的知识库。这将通过要求居民和研究员在临床旋转期间向主治医生展示基本姑息治疗领域的能力来实现。在认证研究生教育委员会（ACGME）“成果项目”指定的居住教育六个核心教育框架内，将对学习者的熟练程度进行评估。通过要求居民和研究员在多个姑息治疗领域中评估他们的能力，反过来，我们的临床教师将被要求进行这些特定的能力评估。这为我们提供了一种新颖的动力来学习姑息治疗内容。因此，我们认为，关注具有姑息治疗能力的医疗居民的“最终边界”是成熟的，即对关键临床教师的临终护理教育。为此，我们制定了以下特定目的：目标1：为临床教职员工创建特定的工具，以评估医疗居民或在临床旋转期间的监督下，使用医疗居民或肿瘤学研究员在临床旋转期间使用ACGME设定的六个能力领域的质量终止和姑息治疗。目标2：教育我们的内科和医学肿瘤学教师与姑息和临终关怀有关的内容，使他们能够使用AIM 1中创建的评估工具来评估医疗居民和肿瘤学的能力，并在临床转移过程中提供优质姑息治疗和寿命终止护理。目标3：采取基于结果的措施来评估基于能力的教育计划的有效性，以确定我们的内科居民和医学肿瘤学研究员是否遵循良好的姑息治疗和临终护理实践。

项目成果

Institutionalization of a palliative and end-of-life care educational program in a medical school curriculum.

在医学院课程中将姑息治疗和临终关怀教育计划制度化。

• DOI: 10.1089/109662101753381683
• 发表时间: 2001
• 期刊: Journal of palliative medicine.
• 作者: Ross,DD;Fraser,HC;Kutner,JS
• 通讯作者: Kutner,JS

Creative solution for implementation of experiential, competency-based palliative care training for internal medicine residents.

为内科住院医师实施体验式、基于能力的姑息治疗培训的创造性解决方案。

• DOI: 10.1007/s13187-011-0235-x
• 发表时间: 2011
• 期刊: Journal of cancer education : the official journal of the American Association for Cancer Education
• 作者: Ross,DouglasD;Shpritz,DeborahW;Wolfsthal,SusanD;Zimrin,AnnB;Keay,TimothyJ;Fang,Hong-Bin;Schuetz,CarlA;Stapleton,LauraM;Weissman,DavidE
• 通讯作者: Weissman,DavidE

Development of required postgraduate palliative care training for internal medicine residents and medical oncology fellows.

为内科住院医师和肿瘤内科研究员开展所需的研究生姑息治疗培训。

• DOI: 10.1207/s15430154jce1902_6
• 发表时间: 2004
• 期刊: Journal of cancer education : the official journal of the American Association for Cancer Education.
• 作者: Ross,DouglasD;Shpritz,Deborah;Alexander,CarlaS;Carter,Kennita;Edelman,MartinJ;Friedley,Nancy;Hemani,Alnoor;Keay,TimothyJ;Roy,SusanC;Silverman,Henry;Tasker,DavidJ;Timmel,Dan;Schwartz,Jack;Wolfsthal,SusanD
• 通讯作者: Wolfsthal,SusanD

Required training in hospice and palliative care at the University of Maryland School of Medicine.

需要在马里兰大学医学院接受临终关怀和姑息治疗方面的培训。

• DOI: 10.1080/08858199909528602
• 发表时间: 1999
• 期刊: Journal of cancer education : the official journal of the American Association for Cancer Education.
• 作者: Ross,DD;Keay,T;Timmel,D;Alexander,C;Dignon,C;O'Mara,A;O'Brien3rd,W
• 通讯作者: O'Brien3rd,W

Hospice and palliative care education in medical school: a module on the role of the physician in end-of-life care.

医学院的临终关怀和姑息治疗教育：关于医生在临终关怀中的作用的模块。

• DOI: 10.1080/08858199709528478
• 发表时间: 1997
• 期刊: Journal of cancer education : the official journal of the American Association for Cancer Education.
• 作者: Ross,DD;O'Mara,A;Pickens,N;Keay,T;Timmel,D;Alexander,C;Hawtin,C;O'Brien3rd,W;Schnaper,N
• 通讯作者: Schnaper,N