Primary care physicians’ educational needs and learning preferences in end of life care: A focus group study in the UK

BMC Palliative Care

Research Article

Shaheen A. Khan¹  Rachel Burman²  Lisa Jane Brighton³  Jonathan Koffman³  Vicky Robinson³  Rob George⁴  Lucy Ellen Selman⁵ 

[1] Guy’s & St Thomas’ NHS Foundation Trust, Great Maze Pond, SE19RT, London, UK;King’s College Hospital NHS Foundation Trust, Bessemer Road, Denmark Hill, SE5 9RS, London, UK;King’s College London, Cicely Saunders Institute, Bessemer Road, Denmark Hill, SE59PJ, London, UK;King’s College London, Cicely Saunders Institute, Bessemer Road, Denmark Hill, SE59PJ, London, UK;St Christopher’s Hospice, 51-59 Lawrie Park Road, SE26 6DZ, London, UK;University of Bristol, School of Social and Community Medicine, University of Bristol, 39 Whatley Road, BS8 2PS, Bristol, UK;

关键词: General Practice;    Primary Health Care;    Education;    End of Life Care;    Palliative Care;    Qualitative Research;   

DOI  :  10.1186/s12904-017-0191-2

 received in 2016-08-01, accepted in 2017-02-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPrimary care physicians (General Practitioners (GPs)) play a pivotal role in providing end of life care (EoLC). However, many lack confidence in this area, and the quality of EoLC by GPs can be problematic. Evidence regarding educational needs, learning preferences and the acceptability of evaluation methods is needed to inform the development and testing of EoLC education. This study therefore aimed to explore GPs’ EoLC educational needs and preferences for learning and evaluation.MethodsA qualitative focus group study was conducted with qualified GPs and GP trainees in the UK. Audio recordings were transcribed and analysed thematically. Expert review of the coding frame and dual coding of transcripts maximised rigour.ResultsTwenty-eight GPs (10 fully qualified, 18 trainees) participated in five focus groups. Four major themes emerged: (1) why education is needed, (2) perceived educational needs, (3) learning preferences, and (4) evaluation preferences. EoLC was perceived as emotionally and clinically challenging. Educational needs included: identifying patients for palliative care; responsibilities and teamwork; out-of-hours care; having difficult conversations; symptom management; non-malignant conditions; and paediatric palliative care. Participants preferred learning through experience, working alongside specialist palliative care staff, and discussion of real cases, to didactic methods and e-learning. 360° appraisals and behavioural assessment using videoing or simulated interactions were considered problematic. Self-assessment questionnaires and patient and family outcome measures were acceptable, if used and interpreted correctly.ConclusionsGPs require education and support in EoLC, particularly the management of complex clinical care and counselling. GPs value mentoring, peer-support, and experiential learning alongside EoLC specialists over formal training.

【 授权许可】

CC BY   
© The Author(s). 2017