Building Primary Palliative Care Capacity Through Education at a National Level: Pallium Canada and its LEAP Courses
Background All the palliative care needs of a population cannot be met by specialist palliative care clinicians and teams alone. Both primary-level and specialist-level palliative care is needed, particularly if palliative care is to be provided to persons with cancer and non-cancer illnesses, an...
| Main Authors: | , , |
|---|---|
| Format: | info:eu-repo/semantics/doctoralThesis |
| Language: | eng |
| Published: |
Universidad de Navarra
2022
|
| Subjects: | |
| Online Access: | https://hdl.handle.net/10171/63672 |
| _version_ | 1795386251469127680 |
|---|---|
| author | Pereira, J.L. (Jose Luis) Centeno, C. (Carlos) Galofre, J.C. (Juan Carlos) |
| author_facet | Pereira, J.L. (Jose Luis) Centeno, C. (Carlos) Galofre, J.C. (Juan Carlos) |
| author_sort | Pereira, J.L. (Jose Luis) |
| collection | DSpace |
| description | Background
All the palliative care needs of a population cannot be met by specialist palliative care clinicians and
teams alone. Both primary-level and specialist-level palliative care is needed, particularly if palliative
care is to be provided to persons with cancer and non-cancer illnesses, and should be initiated early
in the illness journey. However, many healthcare providers who care for patients with serious
illnesses do not have the core competencies to provide a palliative care approach. Education,
including undergraduate, postgraduate and continuing professional development (CPD) of health
care professionals in practice, therefore remains a key strategy to ensure access to palliative care.
Pallium Canada (Pallium) is a non-profit organization that was founded in 2000 to build primary
palliative care capacity nationally across Canada. It has done this largely through its interprofessional
Learning Essential Approaches to Palliative Care (LEAP) courses which target providers across
professions and settings and aims to equip them with core palliative care competencies. LEAP Core is
one of over 17 course versions and targets primary care providers.
Goals and Objectives
The overall goal of my doctoral work was to gain in-depth knowledge and understanding of the
development and spread of continuing palliative care education programs (using Pallium Canada and
its LEAP Core course as case studies), to evaluate the impact of the LEAP courses at various levels,
and to identify evaluation and research priorities for Pallium moving forward.
I approached the work by establishing a series of questions –:
Objective 1: To what extent has Pallium Canada’s LEAP program spread across Canada and
what has facilitated and impeded that spread?
Objective 2: What curriculum development approach has evolved over the years, what are its
features and why?
Objective 3: What are the instructional design approaches that facilitate spread of an
interprofessional palliative care continuing professional development (CPD)
course at a national level, including interprofessional learning?
Objective 4: What is the learner experience of the different profession groups towards
Pallium Canada’s LEAP courses?
Objective 5: Do LEAP Core learners implement what they have learned into their practice?
Objective 6: Do the LEAP Core courses change learners’ knowledge, attitudes and comfort
related to a palliative care approach?
5
Objective 7: What is the impact of LEAP courses on patients and the workplace?
Objective 8: How should Pallium Canada evaluate and study the LEAP program going into the
future?
Methods
A series of case studies (for objectives 1, 2 and 3), two studies (for objectives 4, 5, 6 and 7) and an
environmental scan (for objective 8) were undertaken to address these questions.
Objectives 4, 5 and 6 were addressed with a large analysis, using qualitative and quantitative
methods, of data collected through pre- and post-course instruments that assessed learners’
knowledge (K), attitudes (A) and comfort (C) levels related to providing a palliative care approach
(2015-2017 Study). Learners completed a course evaluation (which included a survey that explored
various facets of the learning experience) immediately post-course and made commitment to change
(CTC) statements (four things they would change in their practices because of participating in the
course). Four months later they reviewed their commitments and reflected on the extent to which
they had implemented them (4-month post-course CTC). All learners who had participated in a LEAP
Core course from 1 April 2015 to 31 March 2017 were eligible.
Objective 7 was addressed with a study of a project called INTEGRATE that included LEAP Core
training in four family medicine clinics in Ontario. It used mixed methods, including surveys and
interviews, of clinic staff (including doctors and nurses and other professionals) and of patients to
assess impact. Four clinics with over 50 staff participated.
Objective 8’s environmental scan included input form national and international education and
evaluation experts, and a critical review of existing evaluation models, frameworks and approaches.
Results
The case studies resulted in three papers. The first mapped out the spread of Pallium across the
country; 17 courses were delivered in the first 3 years in only 3 provinces, while in 2019 alone over
530 courses were delivered to over 10 000 health care professionals across the whole country;
nurses made up the majority of learners (about two thirds), followed by physicians (about a quarter)
and then other professionals). A number of factors were identified that have accelerated spread, as
well as some that impeded it. The second paper described a unique curriculum development
framework that has evolved, includes rapid prototyping methods, and is able to support the
development and maintenance of multiple course versions at the same time. The third paper
identified several instructional design polarities that educators need to navigate to develop short,
interprofessional courses for large scale national deployment.
For the 2015-2017 study, 3045 learners from across professions responded (65.7% response rate).
Over 79% to 97% of learners across professions found the courses relevant to their practices. Similar
rates were found across the other six questions. Differences were noted across the profession
groups though with similar rates expressed by physicians and nurses as a profession group pair, and
by social workers and pharmacists separately. Analyses of the K, A and C surveys found significant
improvements with medium to very large effect sizes across professions. The analysis of the CTC
revealed many examples of learners implementing what they learned into practice.
6
In the INTEGRATE study, healthcare providers found the LEAP course helped them to understand and
provide a palliative care approach better and patients with palliative care needs were identified
earlier, experience more advance care planning and earlier, and were more often connected to
home care services.
The environmental scan identified emerging trends related to evaluation education programs. A
framework that evaluates both impact and implementation was developed, drawing largely on the
Consolidated Framework for Implementation Research and Kirkpatrick’s New World Model.
Conclusions
Pallium Canada and its LEAP program has seen significant spread across Canada. Room for
improvement remains. There is evidence that the course not only improves knowledge, attitudes and
comfort related to providing a palliative care approach, but what is learned is being implemented
into practice with benefits for patients, colleagues, the clinics and learners themselves. |
| format | info:eu-repo/semantics/doctoralThesis |
| id | oai:dadun.unav.edu:10171-63672 |
| institution | Universidad de Navarra |
| language | eng |
| publishDate | 2022 |
| publisher | Universidad de Navarra |
| record_format | dspace |
| spelling | oai:dadun.unav.edu:10171-636722022-06-17T01:04:07Z Building Primary Palliative Care Capacity Through Education at a National Level: Pallium Canada and its LEAP Courses Pereira, J.L. (Jose Luis) Centeno, C. (Carlos) Galofre, J.C. (Juan Carlos) Palliative care Cuidados paliativos Soins palliatifs Pallium Canadá Background All the palliative care needs of a population cannot be met by specialist palliative care clinicians and teams alone. Both primary-level and specialist-level palliative care is needed, particularly if palliative care is to be provided to persons with cancer and non-cancer illnesses, and should be initiated early in the illness journey. However, many healthcare providers who care for patients with serious illnesses do not have the core competencies to provide a palliative care approach. Education, including undergraduate, postgraduate and continuing professional development (CPD) of health care professionals in practice, therefore remains a key strategy to ensure access to palliative care. Pallium Canada (Pallium) is a non-profit organization that was founded in 2000 to build primary palliative care capacity nationally across Canada. It has done this largely through its interprofessional Learning Essential Approaches to Palliative Care (LEAP) courses which target providers across professions and settings and aims to equip them with core palliative care competencies. LEAP Core is one of over 17 course versions and targets primary care providers. Goals and Objectives The overall goal of my doctoral work was to gain in-depth knowledge and understanding of the development and spread of continuing palliative care education programs (using Pallium Canada and its LEAP Core course as case studies), to evaluate the impact of the LEAP courses at various levels, and to identify evaluation and research priorities for Pallium moving forward. I approached the work by establishing a series of questions –: Objective 1: To what extent has Pallium Canada’s LEAP program spread across Canada and what has facilitated and impeded that spread? Objective 2: What curriculum development approach has evolved over the years, what are its features and why? Objective 3: What are the instructional design approaches that facilitate spread of an interprofessional palliative care continuing professional development (CPD) course at a national level, including interprofessional learning? Objective 4: What is the learner experience of the different profession groups towards Pallium Canada’s LEAP courses? Objective 5: Do LEAP Core learners implement what they have learned into their practice? Objective 6: Do the LEAP Core courses change learners’ knowledge, attitudes and comfort related to a palliative care approach? 5 Objective 7: What is the impact of LEAP courses on patients and the workplace? Objective 8: How should Pallium Canada evaluate and study the LEAP program going into the future? Methods A series of case studies (for objectives 1, 2 and 3), two studies (for objectives 4, 5, 6 and 7) and an environmental scan (for objective 8) were undertaken to address these questions. Objectives 4, 5 and 6 were addressed with a large analysis, using qualitative and quantitative methods, of data collected through pre- and post-course instruments that assessed learners’ knowledge (K), attitudes (A) and comfort (C) levels related to providing a palliative care approach (2015-2017 Study). Learners completed a course evaluation (which included a survey that explored various facets of the learning experience) immediately post-course and made commitment to change (CTC) statements (four things they would change in their practices because of participating in the course). Four months later they reviewed their commitments and reflected on the extent to which they had implemented them (4-month post-course CTC). All learners who had participated in a LEAP Core course from 1 April 2015 to 31 March 2017 were eligible. Objective 7 was addressed with a study of a project called INTEGRATE that included LEAP Core training in four family medicine clinics in Ontario. It used mixed methods, including surveys and interviews, of clinic staff (including doctors and nurses and other professionals) and of patients to assess impact. Four clinics with over 50 staff participated. Objective 8’s environmental scan included input form national and international education and evaluation experts, and a critical review of existing evaluation models, frameworks and approaches. Results The case studies resulted in three papers. The first mapped out the spread of Pallium across the country; 17 courses were delivered in the first 3 years in only 3 provinces, while in 2019 alone over 530 courses were delivered to over 10 000 health care professionals across the whole country; nurses made up the majority of learners (about two thirds), followed by physicians (about a quarter) and then other professionals). A number of factors were identified that have accelerated spread, as well as some that impeded it. The second paper described a unique curriculum development framework that has evolved, includes rapid prototyping methods, and is able to support the development and maintenance of multiple course versions at the same time. The third paper identified several instructional design polarities that educators need to navigate to develop short, interprofessional courses for large scale national deployment. For the 2015-2017 study, 3045 learners from across professions responded (65.7% response rate). Over 79% to 97% of learners across professions found the courses relevant to their practices. Similar rates were found across the other six questions. Differences were noted across the profession groups though with similar rates expressed by physicians and nurses as a profession group pair, and by social workers and pharmacists separately. Analyses of the K, A and C surveys found significant improvements with medium to very large effect sizes across professions. The analysis of the CTC revealed many examples of learners implementing what they learned into practice. 6 In the INTEGRATE study, healthcare providers found the LEAP course helped them to understand and provide a palliative care approach better and patients with palliative care needs were identified earlier, experience more advance care planning and earlier, and were more often connected to home care services. The environmental scan identified emerging trends related to evaluation education programs. A framework that evaluates both impact and implementation was developed, drawing largely on the Consolidated Framework for Implementation Research and Kirkpatrick’s New World Model. Conclusions Pallium Canada and its LEAP program has seen significant spread across Canada. Room for improvement remains. There is evidence that the course not only improves knowledge, attitudes and comfort related to providing a palliative care approach, but what is learned is being implemented into practice with benefits for patients, colleagues, the clinics and learners themselves. Introducción No todas las necesidades de cuidados paliativos de la población pueden satisfacerse exclusivamente por los equipos especializados de cuidados paliativos. Se necesitan tanto los cuidados paliativos especializados como los de cuidados paliativos generalistas, en especial si estos cuidados tienen como objeto enfermedades como cáncer u otras, que deben iniciarse tempranamente en el curso de la enfermedad. Sin embargo, muchos profesionales sanitarios que se dedican a los pacientes con enfermedades graves no tienen las competencias clave para brindar el enfoque propio de los cuidados paliativos. La educación, incluida la de pregrado, posgrado, y la educación profesional continuada (CPD, por sus siglas en inglés) de los profesionales de la salud en la práctica, por consiguiente, resultan partes de una estrategia crucial para garantizar el acceso a los cuidados paliativos. Pallium Canadá (Pallium) es una organización sin ánimo de lucro que fue fundada en el año 2000 para desarrollar la capacidad de unos cuidados paliativos generalistas a nivel nacional en Canadá. Esto lo ha logrado ampliamente a través de sus cursos “Aprendiendo Enfoques Esenciales a Cuidados Paliativos” (LEAP, por sus siglas en inglés), que apunta a proveedores estratégicos de distintas profesiones y contextos, e intenta equiparlos con las competencias básicas de los cuidados paliativos. El curso LEAP Core es una de las 17 versiones del curso, dirigido a los sanitarios de atención primaria. Metas y objetivos La principal meta de mi trabajo doctoral era obtener un conocimiento y un entendimiento profundos de la expansión de los programas de educación continuada en cuidados paliativos (empleando Pallium Canadá y su curso LEAP Core como casos de estudio), para evaluar el impacto de los cursos LEAP en varios niveles, y para identificar prioridades de investigación y evaluación para Pallium en el futuro. Enfoqué el trabajo estableciendo una serie de cuestiones: Objetivo 1: ¿Hasta qué punto se expandido el programa LEAP de Pallium Canadá por Canadá y qué ha facilitado o impedido esa expansión? Objetivo 2: ¿Qué enfoque de desarrollo curricular ha evolucionado a lo largo de los años, cuáles son sus características, y por qué? Objetivo 3: ¿Cuáles son los enfoques de diseño educativo que facilitan la expansión de un curso de desarrollo de educación continuada (CPD) en cuidados paliativos interprofesionales a nivel nacional, incluyendo el aprendizaje interprofesional? Objetivo 4: ¿Cuál son las experiencias de los alumnos de los distintos grupos profesionales en los cursos LEAP de Pallium Canadá? Objetivo 5: ¿Ponen en práctica los alumnos lo que han aprendido en los cursos LEAP Core? 8 Objetivo 6: ¿Cambian los cursos LEAP Core los conocimientos, actitudes y el confort relacionados con el enfoque paliativo de los alumnos? Objetivo 7: ¿Cuál es el impacto de los cursos LEAP en los pacientes y en el lugar de trabajo? Objetivo 8: ¿Cómo debería Pallium Canadá evaluar y estudiar el programa LEAP en el futuro? Métodos Una serie de estudios de caso (para los objetivos 1, 2 y 3), dos estudios (para los objetivos 4,5,6 y 7), y un examen del entorno (para el objetivo 8) fueron realizados para abordar estas cuestiones. Los objetivos 4, 5 y 6 fueron abordados con un análisis retrospectivo amplio, utilizando métodos cualitativos y cuantitativos de datos recogidos a través de instrumentos que evaluaban antes y después del curso los niveles de conocimiento (K), actitud (A), y confort (C); relacionados con la provisión de un enfoque de cuidados paliativos (estudio 2015-2017). Los alumnos completaron una evaluación del curso (inclusive una encuesta sobre varias facetas de la experiencia de aprendizaje) inmediatamente después del curso e hicieron declaraciones de compromisos para el cambio (CTC) (cuatro cosas que cambiarían de su práctica por haber participado en el curso). Cuatro meses después revisaron sus compromisos y reflexionaron sobre el grado de implementación. Todos los alumnos que habían participado en el curso LEAP Core desde el 1 de abril de 2015 hasta el 31 de marzo de 2017 fueron elegibles. El objetivo 7 se abordó mediante el estudio de un Proyecto llamado INTEGRATE que incluía formación LEAP Core en cuatro clínicas de medicina de familia en Ontario. Empleaba métodos mixtos, incluyendo encuetas y entrevistas para evaluar el impacto tanto en el personal clínico (médicos, enfermeras y otros profesionales), como en pacientes. Participaron cuatro clínicas con más de 50 profesionales. El examen del entorno del objetivo 8 recibió los aportes de expertos nacionales e internacionales en educación y evaluación, y una revisión crítica de los modelos de evaluación, marcos y enfoques existentes. Resultados Los estudios de caso dieron como resultado tres artículos. El primero mapeó la expansión de Pallium por el país; se realizaron 17 cursos en los tres primeros años en tres provincias, mientras que, sólo en 2019, se impartieron más de 530 cursos a más de 10000 profesionales sanitarios a lo largo y ancho del país; los participantes mayoritarios fueron profesionales de enfermería (casi dos tercios), seguidos por médicos (un cuarto aproximadamente), y otros profesionales. Se identificaron una serie de factores como causantes de la expansión, así como otros que la impidieron. El segundo artículo describió un marco de desarrollo curricular que ha evolucionado, que incluye métodos de prototipado rápido, y capaz de apoyar el desarrollo y mantenimiento de múltiples versiones del curso simultáneamente. El tercer artículo identificó diversas polaridades de diseño educativo que los educadores necesitan para guiar el desarrollo de cursos cortos, interprofesionales, de despliegue nacional a gran escala. Para el estudio de 2015-2017, 3045 alumnos de diversas profesiones respondieron (ratio de 9 respuesta: 65.7%). Entre el 79% y 97% de los alumnos de las distintas profesiones encontraron los cursos útiles para su práctica. Se encontraron ratios similares en las otras seis preguntas. Se percibieron diferencias entre grupos profesionales, si bien los ratios eran semejantes entre médicos y enfermeras, por un lado; y entre trabajadores sociales y farmacéuticos, respectivamente. Los análisis de los cuestionarios sobre K, A y C, encontraron mejoras significativas en todas las profesiones. El análisis del CTC reveló multitud de ejemplos de alumnos que habían implementado lo aprendido en la práctica. En el estudio INTEGRATE, los profesionales sanitarios encontraron que el curso LEAP les ayudó a comprender y a brindar un mejor enfoque de cuidados paliativos, a identificar más precozmente los pacientes con necesidades paliativas, a mejorar la planificación avanzada (y más tempranamente), y a conectarse más frecuentemente con los servicios de atención domiciliaria. El examen de entorno identificó tendencias emergentes relacionadas con la evaluación de los programas educativos. Se desarrolló un marco que evalúa tanto el impacto como la implementación, basándose en el Marco Consolidado de la Investigación de la Implementación y el el Modelo Kirkpatrick para el Nuevo Mundo (MKNM). Conclusiones Pallium Canadá y su programa LEAP, aun con margen de mejora, ha conocido una expansión significativa en Canadá. Hay evidencia de que el curso no sólo mejora el conocimiento, las actitudes y el confort relacionado con la provisión de un enfoque de cuidados paliativos, sino también que lo que se aprende se implementa en la práctica para beneficio de pacientes, colegas, clínicas y los propios alumnos. Contexte Les cliniciens et les équipes spécialisées en soins palliatifs ne peuvent pas combler à eux seuls tous les besoins en soins palliatifs d’une population. Ces soins sont nécessaires, tant au niveau primaire qu’au niveau spécialisé, en particulier pour les personnes atteintes d’un cancer ou d’une autre maladie. De plus, ils doivent être mis en place dès le début de la trajectoire de la maladie. Cependant, de nombreux fournisseurs de soins de santé qui s’occupent de patients atteints de maladies graves ne possèdent pas les compétences de base pour fournir une approche palliative. La formation, y compris l’enseignement de premier, de deuxième et de troisième cycle ainsi le développement professionnel continu (DPC) des professionnels de la santé en exercice, reste donc une stratégie essentielle pour garantir l’accès aux soins palliatifs. Pallium Canada (Pallium) est un organisme sans but lucratif qui a été fondé en 2000 pour renforcer les capacités en matière de soins palliatifs primaires à l’échelle nationale. Il y est parvenu en grande partie grâce à ses cours interprofessionnels LEAP (Les essentiels de l’approche palliative), qui s’adressent aux fournisseurs de soins de toutes les professions et de tous les milieux. Ces cours visent à doter ces professionnels des compétences essentielles en matière de soins palliatifs. Les Fondements du LEAP sont l’une des 17 versions de ces cours et visent les fournisseurs de soins primaires. Buts et objectifs L’objectif global de mon travail de doctorat était d’acquérir une connaissance et une compréhension approfondies de l’élaboration et du déploiement des programmes de formation continue en soins palliatifs (en utilisant Pallium Canada et son cours les Fondements du LEAP comme études de cas); d’évaluer l’impact des cours LEAP à divers niveaux et de déterminer les priorités d’évaluation et de recherche pour Pallium à l’avenir. J’ai abordé le travail en établissant une série de questions : Objectif 1 : Dans quelle mesure le programme LEAP de Pallium Canada s’est-il déployé dans tout le pays et qu’est-ce qui a facilité et entravé ce déploiement? Objectif 2 : Quelle approche de l’élaboration du programme de formation a évolué au fil des ans, quelles sont ses caractéristiques et pourquoi? Objectif 3 : Quelles sont les approches de conception pédagogique qui facilitent le déploiement d’un cours de développement interprofessionnel continu (DPC) en soins palliatifs au niveau national, y compris l’apprentissage interprofessionnel? Objectif 4 : Quelle est l’expérience des apprenants des différents groupes professionnels en ce qui a trait aux cours LEAP de Pallium Canada? Objectif 5 : Les apprenants des Fondements du LEAP mettent-ils en pratique ce qu’ils ont appris? 11 Objectif 6 : Les cours les Fondements du LEAP modifient-ils les connaissances, les attitudes et le degré d’aise des apprenants en ce qui concerne l’approche palliative? Objectif 7 : Quel est l’impact des cours LEAP sur les patients et le lieu de travail? Objectif 8 : Comment Pallium Canada devrait-il évaluer et étudier le programme LEAP à l’avenir? Méthodologie Une série d’études de cas (pour les objectifs 1, 2 et 3), deux études (pour les objectifs 4, 5, 6 et 7) et une analyse de l’environnement (pour l’objectif 8) ont été entreprises pour répondre à ces questions. Les objectifs 4, 5 et 6 ont été abordés à l’aide d’une vaste analyse rétrospective utilisant des méthodes qualitatives et quantitatives, des données recueillies par le biais d’instruments pré et postcours afin d’évaluer les connaissances (K), les attitudes (A) et les degrés d’aise (C) des apprenants en ce qui a trait à l’approche palliative (étude effectuée en 2015-2017). Les apprenants ont rempli une évaluation du cours (qui comprenait un sondage sur diverses facettes de l’expérience d’apprentissage) immédiatement après le cours et ont pris des engagements à effectuer des changements (EEC) (quatre éléments qu’ils changeraient dans leur pratique après avoir participé au cours). Quatre mois plus tard, ils ont revu leurs engagements et évalué à quel point ils les avaient mis en œuvre (EEC post-cours 4 mois plus tard). Tous les apprenants ayant suivi les Fondements du LEAP du 1er avril 2015 au 31 mars 2017 étaient admissibles. L’objectif 7 a été abordé dans le cadre de l’étude d’un projet appelé INTEGRATE, qui comprenait les Fondements du LEAP dans quatre cliniques de médecine familiale en Ontario. Nous avons utilisé des méthodes mixtes, notamment des sondages et des entretiens avec le personnel des cliniques (y compris les médecins, les infirmières et d’autres professionnels) et des patients pour évaluer l’impact des cours. Quatre cliniques comptant plus de 50 employés ont participé. L’analyse de l’environnement en ce qui a trait à l’Objectif 8 comprenait des contributions d’experts nationaux et internationaux en éducation et en évaluation, ainsi qu’un examen critique des modèles, des cadres et des approches d’évaluation existants. Résultats Les études de cas ont donné lieu à trois articles. Le premier cartographie le déploiement des cours de Pallium au pays; 17 cours ont été dispensés au cours des 3 premières années dans seulement 3 provinces, tandis que pour la seule année 2019, plus de 530 cours ont été offerts à plus de 10 000 professionnels de la santé dans tout le pays. Les infirmières constituaient la majorité des apprenants (environ les deux tiers), suivies des médecins (environ un quart), puis des autres professionnels. Nous avons décelé un certain nombre de facteurs favorisant le déploiement, ainsi que ceux qui l’entravaient. Le deuxième article décrit un cadre unique d’élaboration de programmes d’études qui a évolué. Ce cadre comprend des méthodes de prototypage rapide et est capable de soutenir l’élaboration et la mise à jour de plusieurs versions de cours en même temps. Le troisième article décrit plusieurs polarités relatives à la conception pédagogique que les éducateurs doivent surmonter pour créer des cours courts et interprofessionnels destinés à être déployés à grande 12 échelle sur le plan national. Pour l’étude de 2015-2017, 3045 apprenants de toutes les professions ont répondu (taux de réponse de 65,7 %). Plus de 79 % à 97 % des apprenants, toutes professions confondues, ont trouvé les cours pertinents pour leur pratique. Des taux similaires ont été observés pour les six autres questions. Des différences ont été constatées entre les groupes de professions, avec toutefois des taux similaires chez les médecins et les infirmières en tant que paire de groupes professionnels, et chez les travailleurs sociaux et les pharmaciens séparément. Les analyses des sondages K, A et C ont révélé des améliorations importantes avec des tailles d’effet moyennes à très importantes dans toutes les professions. L’analyse de l’EEC a révélé de nombreux exemples d’apprenants mettant en pratique ce qu’ils ont appris. Selon les résultats de l’étude INTEGRATE, les fournisseurs de soins de santé ont trouvé que le cours LEAP les aidait à mieux comprendre l’approche palliative et à l’appliquer, et que les patients ayant des besoins en matière de soins palliatifs étaient identifiés plus tôt, bénéficiaient davantage et plus tôt de la planification préalable des soins, et étaient plus souvent mis en relation avec les services de soins à domicile. L’analyse de l’environnement a permis de cerner les tendances émergentes en matière d’évaluation des programmes de formation. Un cadre permettant d’évaluer à la fois l’impact et la mise en œuvre a été élaboré, en s’inspirant largement du Consolidated Framework for Implementation Research [Cadre consolidé pour la recherche sur la mise en œuvre] et du New World Model [Modèle du Nouveau Monde] de Kirkpatrick. Conclusions Pallium Canada et son programme LEAP ont connu une expansion importante au pays. Des améliorations sont encore possibles. Il est prouvé que le cours améliore non seulement les connaissances, les attitudes et le degré d’aise liés à l’approche palliative, mais aussi que les résultats de l’apprentissage sont appliqués dans la pratique, entraînant des avantages pour les patients, les collègues, les cliniques et les apprenants eux-mêmes. 2022-06-16T06:46:38Z 2022-06-16T06:46:38Z 2022-06-16 2021-11-25 info:eu-repo/semantics/doctoralThesis https://hdl.handle.net/10171/63672 eng info:eu-repo/semantics/openAccess application/pdf Universidad de Navarra |
| spellingShingle | Palliative care Cuidados paliativos Soins palliatifs Pallium Canadá Pereira, J.L. (Jose Luis) Centeno, C. (Carlos) Galofre, J.C. (Juan Carlos) Building Primary Palliative Care Capacity Through Education at a National Level: Pallium Canada and its LEAP Courses |
| title | Building Primary Palliative Care Capacity Through Education at a National Level: Pallium Canada and its LEAP Courses |
| title_full | Building Primary Palliative Care Capacity Through Education at a National Level: Pallium Canada and its LEAP Courses |
| title_fullStr | Building Primary Palliative Care Capacity Through Education at a National Level: Pallium Canada and its LEAP Courses |
| title_full_unstemmed | Building Primary Palliative Care Capacity Through Education at a National Level: Pallium Canada and its LEAP Courses |
| title_short | Building Primary Palliative Care Capacity Through Education at a National Level: Pallium Canada and its LEAP Courses |
| title_sort | building primary palliative care capacity through education at a national level: pallium canada and its leap courses |
| topic | Palliative care Cuidados paliativos Soins palliatifs Pallium Canadá |
| url | https://hdl.handle.net/10171/63672 |
| work_keys_str_mv | AT pereirajljoseluis buildingprimarypalliativecarecapacitythrougheducationatanationallevelpalliumcanadaanditsleapcourses AT centenoccarlos buildingprimarypalliativecarecapacitythrougheducationatanationallevelpalliumcanadaanditsleapcourses AT galofrejcjuancarlos buildingprimarypalliativecarecapacitythrougheducationatanationallevelpalliumcanadaanditsleapcourses |