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Medline ® Abstract for Reference 17

of 'Discussing goals of care'

Creating enduring change: demonstrating the long-term impact of a faculty development program in palliative care.
Sullivan AM, Lakoma MD, Billings JA, Peters AS, Block SD, PCEP Core Faculty
J Gen Intern Med. 2006 Sep;21(9):907-14.
BACKGROUND: Improved educational and evaluation methods are needed in continuing professional development programs.
OBJECTIVE: To evaluate the long-term impact of a faculty development program in palliative care education and practice.
DESIGN: Longitudinal self-report surveys administered from April 2000 to April 2005.
PARTICIPANTS: Physician and nurse educators from North America and Europe. All program graduates (n = 156) were invited to participate.
INTERVENTION: Two-week program offered annually (2000 to 2003) with 2 on-site sessions and 6-month distance-learning period. Learner-centered training addressed teaching methods, clinical skill development, and organizational and professional development.
MEASURES: Self-administered survey items assessing behaviors and attitudes related to palliative care teaching, clinical care, and organizational and professional development at pre-, postprogram, and long-term (6, 12, or 18 months) follow-up.
RESULTS: Response rates: 96% (n = 149) preprogram, 73% (n = 114) follow-up. Participants reported increases in: time spent in palliative care practice (38% preprogram, 47% follow-up, P<.01); use of learner-centered teaching approaches (sum of 8 approaches used "a lot": preprogram 0.7 +/- 1.1, follow-up 3.1 +/- 2.0, P<.0001); and palliative care topics taught (sum of 11 topics taught "a lot": preprogram 1.6 +/- 2.0, follow-up 4.9 +/- 2.9, P<.0001). Reported clinical practices in psychosocial dimensions of care improved (e.g., assessed psychosocial needs of patient who most recently died: 68% preprogram, 85% follow-up, P = .01). Nearly all (90%) reported launching palliative care initiatives, and attributed their success to program participation. Respondents reported major improvements in confidence, commitment to palliative care, and enthusiasm for teaching. Eighty-two percent reported the experience as "transformative."
CONCLUSIONS: This evidence of enduring change provides support for the potential of this educational model to have measurable impact on practices and professional development of physician and nurse educators.
Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA 01984, USA. amy_sullivan@dfci.harvard.edu