What, how and from whom do health care professionals learn during collaboration in palliative home care: a cross-sectional study in primary palliative care

BMC Health Services Research

Myriam Deveugele¹  Bart Van den Eynden³  Ann Stes²  Johan Wens³  Wim Peersman¹  Peter Pype¹ 

[1] Department of Family Medicine and Primary Health Care, Ghent University, UZ-6K3, De Pintelaan 185, Gent 9000, Belgium;Institute for Education and Information Sciences, Institution: University of Antwerp, Antwerp 2610, Belgium;Department: Primary and Interdisciplinary Care Antwerp - PICA, Institution: University of Antwerp, Antwerp 2610, Belgium

关键词: Palliative care;    Primary health care;    Physician-nurse relations;    Interdisciplinary communication;    Workplace learning;   

Others  :  1092244
DOI  :  10.1186/s12913-014-0501-9

 received in 2014-05-29, accepted in 2014-10-06,  发布年份 2014

【 摘 要 】

Background

Palliative care often requires inter-professional collaboration, offering opportunities to learn from each other. General practitioners often collaborate with specialized palliative home care teams. This study seeks to identify what, how and from whom health care professionals learn during this collaboration.

Methods

Cross-sectional survey in Belgium. All palliative home care teams were invited to participate. General practitioners (n = 267) and palliative care nurses (n = 73) filled in questionnaires.

Results

General practitioners (GPs) and palliative care nurses learned on all palliative care aspects. Different learning activities were used. Participants learned from all others involved in patient care. The professionals’ discipline influences the content, the way of learning and who learns from whom. Multiple linear regression shows significant but limited association of gender with amount of learning by GPs (M < F; p = 0.042; Adj R² = 0.07) and nurses (M > F; p = 0.019; Adj R² = 0.01).

Conclusions

This study is the first to reveal what, how and from whom learning occurs during collaboration in palliative care. Training professionals in sharing expertise during practice and in detecting and adequately responding to others’ learning needs, could optimize this way of learning.

【 授权许可】

   
2014 Pype et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Sepúlveda C, Marlin A, Yoshida T, Ullrich A: Palliative care: the World Health Organization’s global perspective. J Pain Symptom Manage 2002, 24:91-96.
• [2][http://www.who.int/hrh/resources/framework_action/en/] webcite WHO 2010 Framework for Action on Interprofessional Education & Collaborative Practice []
• [3]Gomes B, Calanzani N, Curiale V, McCrone P, Higginson IJ: Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers. Cochrane Database Syst Rev 2013, Issue 6:Art.No.:CD007760. doi:10.1002/14651858.CD007760.pub2
• [4]Gamondi C, Larkin P, Payne S: Core competencies in palliative care: an EAPC white paper on palliative care education – part 1. EJPC 2013, 20(2):86-91.
• [5]Gamondi C, Larkin P, Payne S: Core competencies in palliative care: an EAPC white paper on palliative care education – part 2. EJPC 2013, 20(3):140-145.
• [6]Centeno C, Lynch T, Donea O, Rocafort J, Clark D: EAPC Atlas of Palliative Care in Europe 2013 – Full Edition. EAPC Press, Milan; 2013.
• [7]Mitchell G: How well do general practitioners deliver palliative care? A systematic review. Palliat Med 2002, 16:457-464.
• [8]Lave J, Wenger E: Situated Learning: Legitimate Peripheral Participation. Cambridge University Press, Cambridge; 1991.
• [9]Parboosingh J: Physician communities of practice: where learning and practice are inseparable. J Contin Educ Health Prof 2002, 22:230-236.
• [10]Hammick M, Olckers L, Campion-Smith C: Learning in interprofessional teams: AMEE Guide no 38. Med Teach 2009, 31:1-12. doi:10.1080/01421590802585561
• [11]Kilminster S, Cottrell D, Grant J, Jolly B: AMEE guide no. 27: effective educational and clinical supervision. Med Teach 2007, 29:2-19.
• [12]Goldman E, Plack M, Roche C, Smith J, Turley C: Learning in a chaotic environment. J Workplace Learn 2007, 21:555-574.
• [13]Boud D, Middleton H: Learning from others at work: communities of practice and informal learning. J Workplace Learn 2003, 15:194-202.
• [14]Berg S, Chyung S: Factors that influence informal learning in the workplace. J Workplace Learn 2008, 20:229-244.
• [15]Le Clus M: Informal learning in the workplace: a review of the literature. Aust J Adult Learn 2011, 51:355-373.
• [16]Eraut M: Learning from other people in the workplace. Oxf Rev Educ 2007, 33:403.
• [17]Illeris K: A model for learning in working life. J Workplace Learn 2004, 16:431-441.
• [18]Billet S: Workplace participatory practices – conceptualizing workplaces as learning environments. J Workplace Learn 2004, 16:312-324.
• [19]Williams C: Understanding the essential elements of work-based learning and its relevance to everyday clinical practice. J Nurs Manag 2010, 18:624-632.
• [20][http://www.eapcnet.org] webcite Elsner F, Centeno C, De Conno F, Ellershaw J, Eychmuller S, Filbet M, Kaasa S, Larkin P: Recommendations of the EAPC for the Development of Postgraduate Curricula Leading to Certification in Palliative Medicine. 2009, []
• [21]Parsell G, Bligh J: The development of a questionnaire to assess the readiness of health care students for interprofessional learning (RIPLS). Med Educ 1999, 33:95-100.
• [22]Reid R, Bruce D, Allstaff K, McLernon D: Validating the Readiness for Interprofessional Learning Scale (RIPLS) in the postgraduate context: are health care professionals ready for IPL? Med Educ 2006, 40:415-422.
• [23]Thannhauser J, Russell-Mayhew S, Scott C: Measures of interprofessional education and collaboration. J Interprof Care 2010, 24:336-349. doi:10.3109/13561820903442903
• [24]Beatty P, Gordon B: The practice of cognitive interviewing. Public Opin Q 2007, 71:287-311.
• [25]Pype P, Stes A, Wens J, Van den Eynden B, Deveugele M: The landscape of postgraduate education in palliative care for general practitioners: results of a nationwide survey in Flanders, Belgium. Patient Educ Couns 2012, 86:220-225. doi:10.1016/j.pec.2011.05.025
• [26]Leemans K, Van den Block L, Bilsen J, Cohen J, Boffin N, Deliens L: Dying at home in Belgium: a descriptive GP interview study. BMC Fam Pract 2012, 19:13-14. doi:10.1186/1471-2296-13-4
• [27]Shipman C, Addington-Hall J, Barclay S, Briggs J, Cox I, Daniels L, Millar D: Educational opportunities in palliative care: what do general practitioners want? Palliat Med 2001, 15:191-196.
• [28]Low J, Cloherty M, Wilkinson S, Barclay S, Hibble A: A UK-wide postal survey to evaluate palliative care education amongst General Practice Registrars. Palliat Med 2006, 20:463-469.
• [29]Meijler WJ, Van Heest F, Otter R, Sleijfer DT: Educational needs of general practitioners in palliative care: outcome of a focus group study. J Cancer Educ 2005, 20:28-33.
• [30]Barclay S, Todd C, Grande G, Lipscombe J: How common is medical training in palliative care? A postal survey of general practitioners. Br J Gen Pract 1997, 47:800-804.
• [31]Veloski J, Boex JR, Grasberger MJ, Evans A, Wolfson D: Systematic review of the literature on assessment, feedback and physicians’ clinical performance: BEME Guide No. 7. Med Teach 2006, 28:117-128.
• [32]Cantillon P, Sargeant J: Giving feedback in clinical settings. BMJ 2008, 10:337:a1961.
• [33]Alonso A, Baker D, Holtzman A, Day R, King D, Toomey L, Salas E: Reducing medical error in the military health system: how can team training help? Hum Resour Manage R 2006, 16:396-415.
• [34]Bedwell WL, Ramsay PS, Salas E: Helping fluid teams work: a research agenda for effective team adaptation in healthcare. Transl Behav Med 2012, 2:504-509. doi:10.1007/s13142-012-0177-9
• [35]Klemenc-Ketis Z, Vanden Bussche P, Rochefort A, Emaus C, Eriksson T, Kersnik J: Teaching quality improvement in family medicine. Educ Prim Care 2012, 23:378-381.
• [36]Bowie P, Skinner J, de Wet C: Training health care professionals in root cause analysis: a cross-sectional study of post-training experiences, benefits and attitudes. BMC Health Serv Res 2013, 13:50. doi:10.1186/1472-6963-13-50 BioMed Central Full Text
• [37]Henriksson A, Arestedt K: Exploring factors and caregiver outcomes associated with feelings of preparedness for caregiving in family caregivers in palliative care: a correlational, cross-sectional study. Pall Med 2013, 27:639-646.
• [38]Tennant M: Is learning transferable? In Understanding Learning at Work. Edited by Boud D, Garrick J. Routledge, London; 1999.
• [39]Crebert G, Bates M, Bell B, Patrick C, Cragnolini V: Developing generic skills at university, during work placement and in employment: graduates’ perceptions. High Educ Res Dev 2004, 24:147-165.
• [40]Kalyuga S: Instructional designs for the development of transferable knowledge and skills: a cognitive load perspective. Comput Hum Behav 2009, 25:332-338.
• [41]Pype P, Symons L, Wens J, Van den Eynden B, Stess A, Cherry G, Deveugele M: Healthcare professionals’ perceptions toward interprofessional collaboration in palliative home care: a view from Belgium. J Interprof Care 2013, 27:313-319. doi:10.3109/13561820.2012.745488
• [42]Burford B, Morrow G, Morrison J, Baldauf B, Spencer J, Johnson N, Rothwell C, Peile E, Davies C, Allen M, Illing J: Newly qualified doctors’ perceptions of informal learning from nurses: implications for interprofessional education and practice. J Interprof Care 2013, 27:394-400.