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.
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.