Thomas Fassier1, Amandine Rapp2, Jan-Joost Rethans3, Mathieu Nendaz4, Naïke Bochatay5. 1. is Director, Interprofessional Simulation Center, Geneva, Switzerland, Faculty, Unit for Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland, and Attending Physician, Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland. 2. is Research Assistant, UDREM, Faculty of Medicine, University of Geneva, Geneva, Switzerland. 3. is Professor of Human Simulation, Skillslab, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands. 4. is Director, UDREM, Faculty of Medicine, and Vice Dean, School of Medicine, University of Geneva, Geneva, Switzerland, and Professor, Internal Medicine Department, Geneva University Hospitals, Geneva, Switzerland. 5. is Postdoctoral Scholar, Department of Pediatrics, University of California, and Research Assistant, UDREM, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Abstract
BACKGROUND: Residents may learn how to perform advance care planning (ACP) through informal curriculum. Task-based instructional designs and recent international consensus statements for ACP provide opportunities to explicitly train residents, but residents' needs are poorly understood. OBJECTIVE: We assessed residents' training needs in ACP at the Geneva University Hospitals in Geneva, Switzerland. METHODS: Qualitative data were collected and analyzed iteratively between December 2017 and September 2019. Transcripts were coded using both a deductive content analysis based on the 4-Component Instructional Design (4C/ID) model and an inductive thematic analysis. RESULTS: Out of 55 individuals contacted by email, 49 (89%) participated in 7 focus groups and 10 individual interviews, including 19 residents, 18 fellows and attending physicians, 4 nurses, 1 psychologist, 1 medical ethics consultant, 3 researchers, and 3 patients. Participants identified 3 tasks expected of residents (preparing, discussing, and documenting ACP) and discussed why training residents in ACP is complex. Participants described knowledge (eg, prognosis), skills (eg, clinical and ethical reasoning), and attitudes (eg, reflexivity) that residents need to become competent in ACP and identified needs for future training. In terms of the 4C/ID, these needs revolved around: (1) learning tasks (eg, workplace practice, simulated scenarios); (2) supportive information (eg, videotaped worked examples, cognitive feedback); (3) procedural information (eg, ACP pocket-sized information sheet, corrective feedback); and (4) part-task practice (eg, rehearsal of communication skills, simulation). CONCLUSIONS: This study provides a comprehensive description of tasks and competencies to train residents in ACP.
BACKGROUND: Residents may learn how to perform advance care planning (ACP) through informal curriculum. Task-based instructional designs and recent international consensus statements for ACP provide opportunities to explicitly train residents, but residents' needs are poorly understood. OBJECTIVE: We assessed residents' training needs in ACP at the Geneva University Hospitals in Geneva, Switzerland. METHODS: Qualitative data were collected and analyzed iteratively between December 2017 and September 2019. Transcripts were coded using both a deductive content analysis based on the 4-Component Instructional Design (4C/ID) model and an inductive thematic analysis. RESULTS: Out of 55 individuals contacted by email, 49 (89%) participated in 7 focus groups and 10 individual interviews, including 19 residents, 18 fellows and attending physicians, 4 nurses, 1 psychologist, 1 medical ethics consultant, 3 researchers, and 3 patients. Participants identified 3 tasks expected of residents (preparing, discussing, and documenting ACP) and discussed why training residents in ACP is complex. Participants described knowledge (eg, prognosis), skills (eg, clinical and ethical reasoning), and attitudes (eg, reflexivity) that residents need to become competent in ACP and identified needs for future training. In terms of the 4C/ID, these needs revolved around: (1) learning tasks (eg, workplace practice, simulated scenarios); (2) supportive information (eg, videotaped worked examples, cognitive feedback); (3) procedural information (eg, ACP pocket-sized information sheet, corrective feedback); and (4) part-task practice (eg, rehearsal of communication skills, simulation). CONCLUSIONS: This study provides a comprehensive description of tasks and competencies to train residents in ACP.
Authors: Rebecca L Sudore; Daren K Heyland; Deborah E Barnes; Michelle Howard; Konrad Fassbender; Carole A Robinson; John Boscardin; John J You Journal: J Pain Symptom Manage Date: 2016-12-29 Impact factor: 3.612
Authors: Tasnim Sinuff; Peter Dodek; John J You; Doris Barwich; Carolyn Tayler; James Downar; Michael Hartwick; Christopher Frank; Henry T Stelfox; Daren K Heyland Journal: J Pain Symptom Manage Date: 2015-01-24 Impact factor: 3.612