Discovering What Works Well: Exploring Primary Palliative Care Education in Pediatrics Residency Programs in Canada.

IF 2.8 3区 医学 Q1 PEDIATRICS
Naomi Goloff, Lea Sultanem, Alexis Fong-Leboeuf, Estee Grant, Elizabeth Anne Kinsella, Joanna Humphries, Robin Williams, Daniëlle Verstegen, Erin Kwolek
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引用次数: 0

Abstract

Background: Pediatricians require primary palliative care (PC) skills - communication, pain and symptom management, and psychosocial support - to provide care that mitigates suffering for children with serious illnesses. Residents may not develop skills adequately, and little is known about how they learn those that they do have.

Objective: To explore effective primary PC learning in Canadian pediatrics residency programs.

Methods: Using Appreciative Inquiry methodology, we focused on 'what is working well' to explore resident learning. We purposively sampled 17 trainees (post-graduate years 3-5), representing 13/17 programs. Participants engaged in semi-structured interviews, which we transcribed and analyzed iteratively through an inductive thematic process.

Results: The findings highlighted two predominant themes: a) Embracing incidental learning in the workplace, and b) Scaffolding learning through balanced structure and autonomy. Subthemes included: Recognizing the value of informal and unexpected learning opportunities; Strategies for harnessing incidental learning; Fostering interprofessional collaboration for learning; Integrating PC throughout training; Balancing structured learning with workplace-based opportunities for skill development; and the importance of graduated responsibility in workplace learning.

Conclusions: The residency learning environment provides a rich milieu to develop primary PC skills, but it is often difficult to make use of the fragmented learning opportunities. Residents rely significantly on unplanned clinical opportunities and must actively engage in planning, monitoring, and reflecting on their experiences to develop these skills. Our study underscores the importance of a multi-faceted approach to acquisition of PC skills - through experiential learning, reflective practice, graded responsibility, mentorship opportunities - spread throughout the duration of training.

发现什么是有效的:探索初级姑息治疗教育在儿科住院医师计划在加拿大。
背景:儿科医生需要初级姑息治疗(PC)技能——沟通、疼痛和症状管理以及社会心理支持——以提供护理,减轻患有严重疾病的儿童的痛苦。住院医生可能无法充分发展技能,而且他们如何学习已经掌握的技能也知之甚少。目的:探讨加拿大儿科住院医师项目中有效的初级PC学习。方法:使用欣赏式探究方法,我们关注“什么是有效的”来探索居民学习。我们有针对性地抽样了17名学员(研究生3-5年),代表了13/17个项目。参与者参与了半结构化访谈,我们通过归纳主题过程对其进行转录和迭代分析。结果:研究结果突出了两个主要主题:a)在工作场所接受偶然学习,b)通过平衡结构和自主性进行脚手架学习。分主题包括:认识非正式和意外学习机会的价值;利用附带学习的策略;促进跨专业合作学习;在整个培训过程中整合PC;平衡结构化学习与基于工作场所的技能发展机会;以及在工作场所学习中逐步承担责任的重要性。结论:住院医师的学习环境为培养初级计算机技能提供了丰富的环境,但往往难以利用碎片化的学习机会。住院医生很大程度上依赖于计划外的临床机会,必须积极参与计划、监测和反思他们的经验,以发展这些技能。我们的研究强调了在整个培训过程中,通过体验式学习、反思性实践、分级责任、指导机会等多方面方法来获得计算机技能的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Academic Pediatrics
Academic Pediatrics PEDIATRICS-
CiteScore
4.60
自引率
12.90%
发文量
300
审稿时长
60 days
期刊介绍: Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.
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