Training Residents in Advance Care Planning: A Task-Based Needs Assessment Using the 4-Component Instructional Design.

Advance Care Planning Curriculum Health Personnel Humans Internship and Residency Needs Assessment

Journal

Journal of graduate medical education
ISSN: 1949-8357
Titre abrégé: J Grad Med Educ
Pays: United States
ID NLM: 101521733

Informations de publication

Date de publication:
Aug 2021
Historique:
received: 21 10 2020
revised: 10 02 2021
revised: 14 04 2021
accepted: 15 04 2021
entrez: 26 8 2021
pubmed: 27 8 2021
medline: 28 8 2021
Statut: ppublish

Résumé

Residents may learn how to perform advance care planning (ACP) through informal curriculum. Task-based instructional designs and recent international consensus statements for ACP provide opportunities to explicitly train residents, but residents' needs are poorly understood. We assessed residents' training needs in ACP at the Geneva University Hospitals in Geneva, Switzerland. Qualitative data were collected and analyzed iteratively between December 2017 and September 2019. Transcripts were coded using both a deductive content analysis based on the 4-Component Instructional Design (4C/ID) model and an inductive thematic analysis. Out of 55 individuals contacted by email, 49 (89%) participated in 7 focus groups and 10 individual interviews, including 19 residents, 18 fellows and attending physicians, 4 nurses, 1 psychologist, 1 medical ethics consultant, 3 researchers, and 3 patients. Participants identified 3 tasks expected of residents (preparing, discussing, and documenting ACP) and discussed why training residents in ACP is complex. Participants described knowledge (eg, prognosis), skills (eg, clinical and ethical reasoning), and attitudes (eg, reflexivity) that residents need to become competent in ACP and identified needs for future training. In terms of the 4C/ID, these needs revolved around: (1) learning tasks (eg, workplace practice, simulated scenarios); (2) supportive information (eg, videotaped worked examples, cognitive feedback); (3) procedural information (eg, ACP pocket-sized information sheet, corrective feedback); and (4) part-task practice (eg, rehearsal of communication skills, simulation). This study provides a comprehensive description of tasks and competencies to train residents in ACP.

Sections du résumé

BACKGROUND BACKGROUND
Residents may learn how to perform advance care planning (ACP) through informal curriculum. Task-based instructional designs and recent international consensus statements for ACP provide opportunities to explicitly train residents, but residents' needs are poorly understood.
OBJECTIVE OBJECTIVE
We assessed residents' training needs in ACP at the Geneva University Hospitals in Geneva, Switzerland.
METHODS METHODS
Qualitative data were collected and analyzed iteratively between December 2017 and September 2019. Transcripts were coded using both a deductive content analysis based on the 4-Component Instructional Design (4C/ID) model and an inductive thematic analysis.
RESULTS RESULTS
Out of 55 individuals contacted by email, 49 (89%) participated in 7 focus groups and 10 individual interviews, including 19 residents, 18 fellows and attending physicians, 4 nurses, 1 psychologist, 1 medical ethics consultant, 3 researchers, and 3 patients. Participants identified 3 tasks expected of residents (preparing, discussing, and documenting ACP) and discussed why training residents in ACP is complex. Participants described knowledge (eg, prognosis), skills (eg, clinical and ethical reasoning), and attitudes (eg, reflexivity) that residents need to become competent in ACP and identified needs for future training. In terms of the 4C/ID, these needs revolved around: (1) learning tasks (eg, workplace practice, simulated scenarios); (2) supportive information (eg, videotaped worked examples, cognitive feedback); (3) procedural information (eg, ACP pocket-sized information sheet, corrective feedback); and (4) part-task practice (eg, rehearsal of communication skills, simulation).
CONCLUSIONS CONCLUSIONS
This study provides a comprehensive description of tasks and competencies to train residents in ACP.

Identifiants

DOI: 10.4300/JGME-D-20-01263.1 PMID: 34434514 PMC: PMC8370360
pubmed: 34434514
doi: 10.4300/JGME-D-20-01263.1
pmc: PMC8370360
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

534-547

Déclaration de conflit d'intérêts

Conflict of interest: The authors declare they have no competing interests.

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Auteurs

Thomas Fassier (T)

is Director, Interprofessional Simulation Center, Geneva, Switzerland, Faculty, Unit for Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland, and Attending Physician, Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.

Amandine Rapp (A)

is Research Assistant, UDREM, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

Jan-Joost Rethans (JJ)

is Professor of Human Simulation, Skillslab, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands.

Mathieu Nendaz (M)

is Director, UDREM, Faculty of Medicine, and Vice Dean, School of Medicine, University of Geneva, Geneva, Switzerland, and Professor, Internal Medicine Department, Geneva University Hospitals, Geneva, Switzerland.

Naïke Bochatay (N)

is Postdoctoral Scholar, Department of Pediatrics, University of California, and Research Assistant, UDREM, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

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Classifications MeSH

questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Planification des soins du patient › Planification anticipée des soins › Training Residents in Advance Care Planning: A...
questionsmedicales.fr › Éducation › Programme d'études › Training Residents in Advance Care Planning: A...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Personnel de santé › Training Residents in Advance Care Planning: A...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Training Residents in Advance Care Planning: A...
questionsmedicales.fr › Éducation › Enseignement professionnel › Enseignement médical › Enseignement spécialisé en médecine › Internat et résidence › Training Residents in Advance Care Planning: A...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Évaluation des besoins › Training Residents in Advance Care Planning: A...