Deborah McLeod1, Mary Jane Esplen2,3,4,5, Jiahui Wong2,3,4,5, Thomas F Hack6,7,8, Lise Fillion9, Doris Howell10,11,12, Margaret Fitch11,13, Julie Dufresne14,15. 1. Psychosocial Oncology, NS Health Authority, School of Nursing, Dalhousie University, Halifax, NS, Canada. 2. de Souza Institute, University Health Network, Toronto, Canada. 3. Faculty of Medicine, University of Toronto, Toronto, Canada. 4. Clinical and Basic Sciences, Department of Psychiatry, University of Toronto, Toronto, Canada. 5. Princess Margaret Cancer Centre, Toronto, Canada. 6. College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnepeg, Canada. 7. Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnepeg, Canada. 8. Psychosocial Oncology & Cancer Nursing Research, I.H. Asper Clinical Research Institute, Winnepeg, Canada. 9. Nursing Research Unit, Centre de Recherche du CHU de Québec, L'Hôtel Dieu de Québec, Quebec, Canada. 10. Oncology Nursing Research and Education, University Health Networks, Toronto, Canada. 11. Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada. 12. Institute for Clinical Evaluative Sciences, Toronto, Canada. 13. Canadian Association of Nurses in Oncology, Toronto, Canada. 14. Yukon Chamber of Commerce, Whitehorse, Yukon, Canada. 15. Touché Consulting, Whitehorse, Yukon, Canada.
Abstract
OBJECTIVE: The Therapeutic Practices for Distress Management (TPDM) project was carried out to support clinicians in integrating recommendations from four clinical practice guidelines (CPGs) in routine care at five Pan Canadian cancer care sites. METHODS: Using a concurrent, mixed-method study design and knowledge translation (KT) activities, this project included two phases: phase I-a baseline/preparation phase and phase II-an intervention phase plus evaluation. The intervention phase (the focus of this report) included a one-year education and supervision program (24 hours in virtual class; 12-hour group supervision). Primary outcomes were knowledge and self-efficacy in practicing CPGs as measured by a Knowledge and Self-Efficacy Survey (KSES). A secondary outcome was observer-rated performances with standardized patients (objective structured clinical exams). Participants included 80 (90%) nurses, and 9 (10%) social workers (N = 89). RESULTS: The TPDM program was effective in accomplishing change in knowledge, self-efficacy, and performance. All measures demonstrated significant change pre and post module, with evidence of increasing knowledge (P < .01) and confidence (P < .01) over time. Further, there was evidence of a shift in barriers and enablers to practicing in alignment with the CPGs. CONCLUSIONS: A tailored education program using case-based learning and supervision over time improves knowledge and practice among front line clinicians. The findings have implications for quality improvement in cancer care.
OBJECTIVE: The Therapeutic Practices for Distress Management (TPDM) project was carried out to support clinicians in integrating recommendations from four clinical practice guidelines (CPGs) in routine care at five Pan Canadian cancer care sites. METHODS: Using a concurrent, mixed-method study design and knowledge translation (KT) activities, this project included two phases: phase I-a baseline/preparation phase and phase II-an intervention phase plus evaluation. The intervention phase (the focus of this report) included a one-year education and supervision program (24 hours in virtual class; 12-hour group supervision). Primary outcomes were knowledge and self-efficacy in practicing CPGs as measured by a Knowledge and Self-Efficacy Survey (KSES). A secondary outcome was observer-rated performances with standardized patients (objective structured clinical exams). Participants included 80 (90%) nurses, and 9 (10%) social workers (N = 89). RESULTS: The TPDM program was effective in accomplishing change in knowledge, self-efficacy, and performance. All measures demonstrated significant change pre and post module, with evidence of increasing knowledge (P < .01) and confidence (P < .01) over time. Further, there was evidence of a shift in barriers and enablers to practicing in alignment with the CPGs. CONCLUSIONS: A tailored education program using case-based learning and supervision over time improves knowledge and practice among front line clinicians. The findings have implications for quality improvement in cancer care.
Authors: Susan Williamson; Thomas F Hack; Munirah Bangee; Valerio Benedetto; Kinta Beaver Journal: Support Care Cancer Date: 2020-06-04 Impact factor: 3.603