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Creating enduring change

Demonstrating the long-term impact of a faculty development program in palliative care

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Abstract

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.

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Correspondence to Amy M. Sullivan EdD.

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None of the authors have any conflicts of interest to declare.

PCEP Core faculty: Janet Abrahm, MD, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; Loring Conant, Jr., MD, Cambridge Hospital, Cambridge, MA, USA, and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Constance Dahlin, RNCS, MSN, OCNS, CHPN, Massachusetts General Hospital, Boston, MA, USA; Marshall Forstein, MD, Cambridge Hospital, Cambridge, MA, USA, and Harvard Medical School, Boston, MA, USA; Paul Montgomery, PhD, Massachusetts General Hospital, Boston, MA, USA; Joanne Wolfe, MD, Dana-Farber Cancer Institute, and Children’s Hospital, Harvard Medical School, Boston, MA, USA.

This program and evaluation were made possible by a grant from the Robert Wood Johnson Foundation. We are grateful to the PCEP participants for their participation in this study.

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Sullivan, A.M., Lakoma, M.D., Billings, J.A. et al. Creating enduring change. J GEN INTERN MED 21, 907–914 (2006). https://doi.org/10.1007/BF02743136

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