PDF(Pubmed)
Abstract：
BACKGROUND: Compassion is positively associated with improved patient outcomes, quality care ratings, and healthcare provider wellbeing. Supporting and cultivating healthcare providers\' compassion through robust and meaningful educational initiatives has been impeded by a lack of conceptual clarity, inadequate content coverage across the domains of compassion, and the lack of validated evaluation tools. The EnACT program aims to address these gaps through an Evidence-informed, competency-based, Applied, Compassion Training program delivered to healthcare providers working in various clinical settings. In this study, we describe the development and initial validation of the program, which will inform and be further evaluated in a forthcoming Randomised Controlled feasibility Trial (RCfT).
METHODS: A multimethod design was used to explore learner needs, experiences, and outcomes associated with the program. Pre- and post-training surveys and qualitative interviews (1 month post training) were conducted among twenty-six healthcare provider learners working in acute care and hospice. Quantitative measures assessed professional fulfillment/burnout, self-confidence in providing compassion, learner satisfaction, and compassion competence. Qualitative interviews explored learners\' experiences of the program, integration of learnings into their professional practice, and program recommendations.
RESULTS: Learners exhibited relatively high self-assessed compassion competence and professional fulfillment pre-training and low levels of burnout. Post-training, learners demonstrated high levels of compassion confidence and satisfaction with the training program. Despite high levels of reported compassion competence pre-training, a statistically significant increase in post-training compassion competence was noted. Thematic analysis identified five key themes associated with learners\' overall experience of the training day and integration of the learnings and resources into their professional practice: (1) A beginner\'s mind: Learner baseline attitudes and assumptions about the necessity and feasibility of compassion training; (2) Learners\' experiences of the training program; (3) Learner outcomes: integrating theory into practice; (4) Creating cultures of compassion; and (5) Learner feedback.
CONCLUSIONS: Findings suggest that the EnACT program is a feasible, rigorous, and effective training program for enhancing healthcare provider compassion. Its evidence-based, patient-informed, clinically relevant content; interactive in class exercises; learner toolkit; along with its contextualized approach aimed at improving the clinical culture learners practice holds promise for sustaining learnings and clinical impact over time-which will be further evaluated in a Randomized Controlled feasibility Trial (RCfT).
METHODS: A multimethod design was used to explore learner needs, experiences, and outcomes associated with the program. Pre- and post-training surveys and qualitative interviews (1 month post training) were conducted among twenty-six healthcare provider learners working in acute care and hospice. Quantitative measures assessed professional fulfillment/burnout, self-confidence in providing compassion, learner satisfaction, and compassion competence. Qualitative interviews explored learners\' experiences of the program, integration of learnings into their professional practice, and program recommendations.
RESULTS: Learners exhibited relatively high self-assessed compassion competence and professional fulfillment pre-training and low levels of burnout. Post-training, learners demonstrated high levels of compassion confidence and satisfaction with the training program. Despite high levels of reported compassion competence pre-training, a statistically significant increase in post-training compassion competence was noted. Thematic analysis identified five key themes associated with learners\' overall experience of the training day and integration of the learnings and resources into their professional practice: (1) A beginner\'s mind: Learner baseline attitudes and assumptions about the necessity and feasibility of compassion training; (2) Learners\' experiences of the training program; (3) Learner outcomes: integrating theory into practice; (4) Creating cultures of compassion; and (5) Learner feedback.
CONCLUSIONS: Findings suggest that the EnACT program is a feasible, rigorous, and effective training program for enhancing healthcare provider compassion. Its evidence-based, patient-informed, clinically relevant content; interactive in class exercises; learner toolkit; along with its contextualized approach aimed at improving the clinical culture learners practice holds promise for sustaining learnings and clinical impact over time-which will be further evaluated in a Randomized Controlled feasibility Trial (RCfT).
摘要：
背景：同情与改善患者预后呈正相关，优质护理评级，和医疗保健提供者的福祉。通过强有力和有意义的教育举措支持和培养医疗保健提供者的同情心一直受到缺乏概念清晰度的阻碍。同情领域的内容覆盖不足，以及缺乏经过验证的评估工具。EnACT计划旨在通过证据知情，以能力为基础，应用,同情培训计划提供给在各种临床环境中工作的医疗保健提供者。在这项研究中,我们描述了该程序的开发和初步验证，这将在即将到来的随机对照可行性试验（RCfT）中提供信息并进行进一步评估。
方法：使用多方法设计来探索学习者的需求，经验,以及与该计划相关的结果。培训前和培训后的调查和定性访谈（培训后1个月）进行了26名在急性护理和临终关怀工作的医疗保健提供者学习者。定量措施评估专业履行/倦怠，提供同情心的自信，学习者满意度，同情能力。定性访谈探索了学习者对该计划的体验，将学习融入他们的专业实践，和方案建议。
结果：学习者表现出相对较高的自我评估的同情能力和培训前的专业成就感以及较低的倦怠水平。培训后,学习者对培训计划表现出高度的同情心信心和满意度。尽管有高水平的同情心能力预培训，观察到训练后同情能力的统计学显著提高.主题分析确定了与学习者在培训日的总体经验以及将学习和资源整合到其专业实践中相关的五个关键主题：（1）初学者的思想：学习者的基线态度以及对必要性和可行性的假设同情培训；（2）学习者对培训计划的经验；（3）学习者的成果：将理论融入实践；（4）创造同情心文化；（5）学习者反馈。
结论：研究结果表明，EnACT计划是可行的，严谨,和有效的培训计划，以增强医疗保健提供者的同情心。它以证据为基础，患者知情,临床相关内容；课堂互动练习；学习者工具包；以及旨在改善临床文化学习者实践的情境化方法，有望随着时间的推移维持学习和临床影响，这将在随机对照可行性试验（RCfT）中进一步评估。
方法：使用多方法设计来探索学习者的需求，经验,以及与该计划相关的结果。培训前和培训后的调查和定性访谈（培训后1个月）进行了26名在急性护理和临终关怀工作的医疗保健提供者学习者。定量措施评估专业履行/倦怠，提供同情心的自信，学习者满意度，同情能力。定性访谈探索了学习者对该计划的体验，将学习融入他们的专业实践，和方案建议。
结果：学习者表现出相对较高的自我评估的同情能力和培训前的专业成就感以及较低的倦怠水平。培训后,学习者对培训计划表现出高度的同情心信心和满意度。尽管有高水平的同情心能力预培训，观察到训练后同情能力的统计学显著提高.主题分析确定了与学习者在培训日的总体经验以及将学习和资源整合到其专业实践中相关的五个关键主题：（1）初学者的思想：学习者的基线态度以及对必要性和可行性的假设同情培训；（2）学习者对培训计划的经验；（3）学习者的成果：将理论融入实践；（4）创造同情心文化；（5）学习者反馈。
结论：研究结果表明，EnACT计划是可行的，严谨,和有效的培训计划，以增强医疗保健提供者的同情心。它以证据为基础，患者知情,临床相关内容；课堂互动练习；学习者工具包；以及旨在改善临床文化学习者实践的情境化方法，有望随着时间的推移维持学习和临床影响，这将在随机对照可行性试验（RCfT）中进一步评估。
