内科住院医师姑息医学基础培训:在瑞士试点测试加拿大模式

A. S. Ebneter, Ebru Kaya, Petra Mair, Barbara Affollter, Steffen Eychmueller
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摘要

背景:在瑞士,姑息关怀(PC)的临床培训在本科生和专科研究生层次上已经得到了很好的确立。然而,非专科医生研究生培训课程的记录较少。当地存在的问题:在专门的姑息治疗病房中,缺乏针对内科(IM)非专科医生轮转的结构化课程。目标:为瑞士 PC 病房的内科住院医师试点两个版本的 PC 非专科课程。方法:在试点阶段,使用混合方法在线调查评估了两种课程:短期浸入式课程(3-10 周,基于多伦多大学内科 PC 轮转)和标准非专科课程(11-18 周,基于加拿大姑息治疗医师协会能力)。一所大学和两所非大学院校参与了调查。分析为描述性分析。结果如下五个培训轮转(2023 年 7 月至 10 月)的五名住院医师和八名督导进行了回复。总体而言,所有小组对课程质量和可行性(内容和时间)都给予了积极评价,对组织、教学设计、学习支持、氛围、体验和设施的满意度都很高。非大学教学点的评价普遍高于大学教学点。定性反馈与这些结果相吻合,强调了课程的相关性和与学习者需求的契合度,并提出了可能的简化和更加个性化的规划建议。结论为 PC 课程设置短期标准课程是可行的,并受到了非专业学员的欢迎。今后的实施应侧重于个性化的学习目标,并精简能力的内容和结构。在不同的培训环境(大学和地区医院)以及国际层面(如加拿大-瑞士)开展合作,可进一步提高拟议培训模式的质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Basic Training in Palliative Medicine for Internal Medicine Residents: Pilot Testing of a Canadian Model in Switzerland
Background: In Switzerland, palliative care (PC) clinical training is well established at undergraduate and specialist postgraduate levels. However, postgraduate nonspecialist training curricula are less documented. Local Problem: A structured curriculum for nonspecialist rotation within internal medicine (IM) in specialized PC wards is lacking. Objective: To pilot two versions of a PC nonspecialist curriculum for IM residents in Swiss PC units. Methods: In the pilot phase, two curricula—short immersion (3–10 weeks, based on the University of Toronto's Internal-Medicine PC Rotation) and standard nonspecialist (11–18 weeks, based on the Canadian Society of Palliative Care Physician Competencies)—were assessed using a mixed-method online survey. One university and two nonuniversity sites participated. The analysis was descriptive. Results: Five residents and eight supervisors of five training rotations (July–October 2023) responded. Overall, curriculum quality and feasibility (content and time) received positive ratings across all groups, with high satisfaction concerning organization, educational design, learning support, climate, experience, and facilities. Nonuniversity sites were generally rated more positively than university sites. Qualitative feedback paralleled these findings, highlighting the curriculum's relevance and fit with learners' needs and suggesting potential simplifications and more personalized planning. Conclusions: Establishing short and standard duration curricula for a PC program is viable and well received by nonspecialist trainees. Future implementation should concentrate on personalized learning objectives and streamlining the content and structure of the competencies. Cooperation within various training settings (university and regional hospitals) as well as on an international level (e.g., Canada–Switzerland) may further improve the quality of the proposed training formats.
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