Palliative Care Curriculum for Medical Residents

住院医师姑息治疗课程

• 批准号: 6928743
• 负责人: CHARLES F VON GUNTEN
• 金额: $ 25.49万
• 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/6928743
• 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，医生没有接受过足够的姑息治疗培训。 在初步工作中，我们已经为医生制定了评估方法和课程，并建立了一个临终关怀轮换65名住院医师培训，每年在三个内科项目和两个家庭医学项目。 我们假设，临终关怀轮换使用国家课程的姑息治疗教育的医生将导致可衡量的改善知识，态度和技能。 研究的主要终点是一个经过验证的36项知识问题的得分，该问题有一个国家参考数据库。 次要终点是姑息治疗的信心和能力的自我评分。 我们将测试这一假设应用相同的课程，以65居民三个从五个不同的培训计划，每年五年。 项目将在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EPEC课程的四个模块，这是一个国家课程，涵盖了使用互联网自学的医生的姑息治疗核心能力。 教师将帮助学生应用的态度，知识和技能，在临床接触到病人在住院和家庭临终关怀设置。 住院医师将展示与标准化患者的沟通技巧。 这些仪器将在住院医师培训的最后两个月内重新使用。 将使用心理测量学上的等同知识考试，以防止重复考试时回忆起项目。 我们将使用单组时间序列设计来分析数据。 在三年的住院医师培训期间，将在四个时间段管理三种评估工具包- Pre 1（住院医师开始）; Pre 2（开始轮换）; Post 1（完成轮换）; Post 2（完成住院医师）。 一组时间序列设计使我们能够评估所有住院医师项目主任在三年培训期内寻求纳入姑息治疗课程时所考虑的问题：1）如果课程是必修课与选修课，课程会产生什么影响？ 2)需要多长时间轮换？ 换句话说，时间对任务的影响是什么？ 3)3年的住院医师轮换应该在什么时候进行，是开始还是结束？ 4)内科和家庭医生之间是否有差异？ 5)培训项目的类型（大学医院、社区教学医院、军队医院）对信息的保留有影响吗？以及6）是否有证据表明这些不同因素之间存在年度相互作用？