Training physicians to provide basic-level palliative care: an evaluation of a novel training programme

We have been aware for a while that there are disparities in specialist skill provision both between and within deaneries – and the SAC is working hard to identify problems in this area. More recently, the issue of funding for specialist skills has been raised. It seems that some deaneries are happy and able to contribute towards the cost of training in a particular skill, while others are not; in at least one deanery, part-funding has now been withdrawn, leaving trainees to cover the entire cost of their chosen skills training. As specialist skill training is now a mandatory part of the Acute Medicine curriculum, we need to find a way to eliminate disparity both between different deaneries and between different skills. However, there is no easy solution, and for the time being, trainees will have to factor in the potential financial implications of a particular skill when they are considering their options. On a brighter note, the list of recognised specialist skills has increased over the past year. Palliative Care has been authorised as a suitable skill, and Medical Ethics and Law will soon also be added to the list. If you would like to propose a skill that is not currently listed in the Acute Medicine curriculum, you should discuss it with your training programme director, who can bring the proposal to the Acute Medicine Specialty Advisory Committee (SAC).

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Palliative care training addressed to hospital healthcare professionals by palliative care specialists: a mixed-method evaluation

BMC Palliative Care ◽

10.1186/s12904-019-0476-8 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Giovanna Artioli ◽

Gabriele Bedini ◽

Elisabetta Bertocchi ◽

Luca Ghirotto ◽

Silvio Cavuto ◽

...

Keyword(s):

Qualitative Research ◽

Palliative Care ◽

Mixed Method ◽

Health Care Professionals ◽

Healthcare Professionals ◽

Training Evaluation ◽

Hospital Setting ◽

Training Programme ◽

Method Evaluation ◽

Advanced Illness

Abstract Background Despite the great advances in the concept of palliative care (PC) and its benefits, its application seems to be delayed, leaving unfulfilled the many needs of patients and family members. One way to overcome this difficulty could be to develop a new training programme by palliative care specialists to improve PC primary skills in healthcare professionals. The aim of this study was to evaluate the training’s impact on trainees within a hospital setting using Kirkpatrick’s and Moore’s models. Methods We adopted a mixed-method evaluation with concurrent triangulation. The evaluation followed the first three steps of Kirkpatrick’s and Moore’s models and included a pre- and post-training evaluation through self-administered questionnaires and focus groups. We used the McNemar statistical test. Results The results highlighted the significant amount of knowledge acquired by the hospital professionals after training, in terms of increasing their knowledge of palliative care and in terms of the change in meaning that they attributed to phenomena related to chronicity and incurability, which they encounter daily in their professional practice. In both quantitative and qualitative research, the results, in synthesis, highlight: (i) the development of a new concept of palliative care, centred on the response to the holistic needs of people; (ii) that palliative care can also be extended to non-oncological patients in advanced illness stages (our training was directed to Geriatrics and Nephrology/Dialysis professionals); (iii) the empowerment and the increase in self-esteem that healthcare professionals gained, from learning about the logistical and structural organization of palliative care, to activate and implement PC; (iv) the need to share personal aspects of their professional life (this result emerges only in qualitative research); (v) the appreciation of cooperation and the joining of multiple competences towards a synergistic approach and enhanced outcomes. Conclusion It is necessary to further develop rigorous research on training evaluation, at the most complex orders of the Kirkpatrick and Moore models, to measure primary PC skills in health care professionals. This will develop the effectiveness of the integration of I- and II-level palliative care competencies in hospitals and improve outcomes of patients’ and families’ quality of life.

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Factors influencing nurse retention within children’s palliative care

Journal of Child Health Care ◽

10.1177/1367493520971426 ◽

2020 ◽

pp. 136749352097142

Author(s):

Lisa Whiting ◽

Michele O’Grady ◽

Mark Whiting ◽

Julia Petty

Keyword(s):

Professional Development ◽

Palliative Care ◽

Focus Groups ◽

Nurse Retention ◽

Training Programme ◽

Positive Influence ◽

Support Provision ◽

Factors Influencing ◽

Inquiry Approach ◽

Making A Difference

Retention of staff presents major challenges within children’s palliative care; this has substantial implications for children, families and the nursing workforce. To address this, a programme was undertaken that provided pathways of professional development for senior nurses working in this field. This study reports the views of nurses completing this programme, the overall project manager (PM) and the day-to-day programme lead (PL) as well as factors that influence nurse retention within children’s palliative care nursing. The study drew on an Appreciative Inquiry approach that comprised of interviews with the PM and PL as well as focus groups and questionnaires with senior nurses from the children’s palliative care sector, who participated in the training programme. Thematic analysis of data from interviews and focus groups revealed factors influencing nurse retention: speciality, positivity and making a difference, support, provision of adequate resources, tailored education/professional development and resilience. These themes were supported by the questionnaire findings. The programme was perceived as having a positive influence on nurse retention within the children’s palliative care workforce. In addition, it was felt to be very beneficial in terms of shared learning and development. Participants highlighted the need for similar opportunities in the future.

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Palliative care training addressed to hospital healthcare professionals by palliative care specialists: a mixed-method evaluation

10.21203/rs.2.13255/v1 ◽

2019 ◽

Author(s):

Giovanna Artioli ◽

Gabriele Bedini ◽

Elisabetta Bertocchi ◽

Luca Ghirotto ◽

Silvio Cavuto ◽

...

Keyword(s):

Qualitative Research ◽

Palliative Care ◽

Mixed Method ◽

Health Care Professionals ◽

Healthcare Professionals ◽

Training Evaluation ◽

Hospital Setting ◽

Training Programme ◽

Method Evaluation ◽

Advanced Illness

Abstract Background Despite the great advances in the concept of palliative care (PC) and its benefits, its application seems to be delayed, leaving unfulfilled the many needs of patients and family members. One way to overcome this difficulty could be to develop a new training programme by palliative care specialists to improve PC primary skills in healthcare professionals The aim of this study was to evaluate the training's impact on trainees within a hospital setting using Kirkpatrick’s and Moore's models. Methods We adopted a mixed-method evaluation with concurrent triangulation. The evaluation followed the first three steps of Kirkpatrick’s and Moore’s models and included a pre- and post-training evaluation through self-administered questionnaires and focus groups. We used the McNemar statistical test. Results The results highlighted the significant amount of knowledge acquired by the hospital professionals after training, in terms of increasing their knowledge of palliative care and in terms of the change in meaning that they attributed to phenomena related to chronicity and incurability, which they encounter daily in their professional practice. In both quantitative and qualitative research, the results, in synthesis, highlight: (i) the development of a new concept of palliative care, centred on the response to the holistic needs of people; (ii) that palliative care can also be extended to non-oncological patients in advanced illness stages (our training was directed to Geriatrics and Nephrology/Dialysis professionals); (iii) the empowerment and the increase in self-esteem that healthcare professionals gained, from learning about the logistical and structural organization of palliative care, to activate and implement PC; (iv) the need to share personal aspects of their professional life (this result emerges only in qualitative research); (v) the appreciation of cooperation and the joining of multiple competences towards a synergistic approach and enhanced outcomes. Conclusion It is necessary to further develop rigorous research on training evaluation, at the most complex levels of the Kirkpatrick and Moore models, to measure primary skills in health care professionals. This will develop the effectiveness of the integration of I- and II-level palliative care competencies in hospitals and improve outcomes of patients’ and families’ quality of life.

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Palliative care training addressed to hospital healthcare professionals by palliative care specialists: a mixed-method evaluation

10.21203/rs.2.13255/v3 ◽

2019 ◽

Author(s):

Giovanna Artioli ◽

Gabriele Bedini ◽

Elisabetta Bertocchi ◽

Luca Ghirotto ◽

Silvio Cavuto ◽

...

Keyword(s):

Qualitative Research ◽

Palliative Care ◽

Mixed Method ◽

Health Care Professionals ◽

Healthcare Professionals ◽

Training Evaluation ◽

Hospital Setting ◽

Training Programme ◽

Method Evaluation ◽

Advanced Illness

Abstract Background Despite the great advances in the concept of palliative care (PC) and its benefits, its application seems to be delayed, leaving unfulfilled the many needs of patients and family members. One way to overcome this difficulty could be to develop a new training programme by palliative care specialists to improve PC primary skills in healthcare professionals. The aim of this study was to evaluate the training's impact on trainees within a hospital setting using Kirkpatrick’s and Moore's models. Methods We adopted a mixed-method evaluation with concurrent triangulation. The evaluation followed the first three steps of Kirkpatrick’s and Moore’s models and included a pre- and post-training evaluation through self-administered questionnaires and focus groups. We used the McNemar statistical test. Results The results highlighted the significant amount of knowledge acquired by the hospital professionals after training, in terms of increasing their knowledge of palliative care and in terms of the change in meaning that they attributed to phenomena related to chronicity and incurability, which they encounter daily in their professional practice. In both quantitative and qualitative research, the results, in synthesis, highlight: (i) the development of a new concept of palliative care, centred on the response to the holistic needs of people; (ii) that palliative care can also be extended to non-oncological patients in advanced illness stages (our training was directed to Geriatrics and Nephrology/Dialysis professionals); (iii) the empowerment and the increase in self-esteem that healthcare professionals gained, from learning about the logistical and structural organization of palliative care, to activate and implement PC; (iv) the need to share personal aspects of their professional life (this result emerges only in qualitative research); (v) the appreciation of cooperation and the joining of multiple competences towards a synergistic approach and enhanced outcomes. Conclusion It is necessary to further develop rigorous research on training evaluation, at the most complex orders of the Kirkpatrick and Moore models, to measure primary PC skills in health care professionals. This will develop the effectiveness of the integration of I- and II-level palliative care competencies in hospitals and improve outcomes of patients’ and families’ quality of life.

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Delirium screening practice in specialist palliative care units: a survey

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-002251 ◽

2020 ◽

pp. bmjspcare-2020-002251

Author(s):

Rebecca Woodhouse ◽

Najma Siddiqi ◽

Jason W Boland ◽

Imogen Featherstone ◽

Miriam J Johnson

Keyword(s):

Palliative Care ◽

Clinical Guidelines ◽

Online Survey ◽

Assessment Tool ◽

Clinical Symptoms ◽

Training Programme ◽

Screening Tools ◽

Specialist Palliative Care ◽

Screening Practice ◽

Palliative Care Units

ObjectivesDelirium is common and distressing in palliative care settings. This survey aims to describe current practice regarding delirium identification in specialist palliative care units (SPCU), such as inpatient hospices, in the UK.MethodsAn 18-item anonymous online survey was distributed by Hospice UK to their network of clinical leads (n=223), and to their research mailing list (n=228). The survey was also sent to the chair of the Hospice UK executive clinical leads forum for direct dissemination to forum representatives (n=20). Clinical leads and forum representatives were asked to distribute the survey to healthcare staff in their SPCUs.Results220 SPCU staff (48% nurses; 31% doctors; 10% healthcare assistants) completed the survey. Approximately half reported using clinical judgement alone to screen (97/204; 48%) and/or diagnose (124/220; 56%) delirium. Over a third used an assessment tool to screen for delirium (76/204; 37%). The majority (150/220; 68%) reported screening in response to clinical symptoms, while few reported routine on-admission (11/220; 5%) or daily-during-admission (12/220; 6%) screening. Most respondents had received some training on delirium (137/220; 62%). However, 130/220 (59%) said their SPCU did not have a training programme for delirium screening and only 79/220 (36%) reported that their SPCU had delirium clinical guidelines. The main barriers to routine screening included: lack of delirium training, lack of guidelines and complexity of patient’s conditions.ConclusionThere is variation in practice for delirium screening and diagnosis in SPCUs. Clinical guidelines for delirium, including consensus on which screening tools to use, are needed for this setting.

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