Faculty Development in End-of-Life Care: Evaluation of a National Train-the-Trainer Program

Abstract

To address serious deficiencies in physician training in end-of-life care, the authors developed and disseminated a faculty development curriculum. The overall goals of this curriculum were to enhance physician competence in end-of-life care, foster a commitment to improving care for the dying, and improve teaching related to end-of-life care. The authors provide descriptions of the curriculum and the train-the-trainer programs (2000-2002) that successfully prepared 17 medical faculty as in-house end-of-life care faculty developers at institutions nationwide. They also report on a study of the effects of the 16-hour, end-of-life care curriculum delivered by trained facilitators to 62 faculty and residents at their home sites. Program evaluation showed that the home-site seminars enhanced the knowledge, skills, and attitudes of participating faculty and residents. When project evaluation concluded in 2003, trained facilitators had disseminated the 16-hour curriculum as well as modified versions of the curriculum to approximately 3,400 medical teachers. An adapted version of the curriculum is available on the Internet for use in health professions education. The importance of this type of faculty development effort was confirmed by the positive impact of the 16-hour curriculum on participants' knowledge, skills, and attitudes related to end-of-life care, the high ratings of the program's educational and clinical relevance, and the finding that, on average, more than 50% of the material was new to them.

Evaluation of the National Train-the-Trainer Program for Hospice and Palliative Care in Korea

“…As the main purpose of this study was to develop the teaching skills of trainers, Kirkpatrick's first three levels of evaluation, which focus on teaching performance, were the most appropriate. Similarly to previous studies (Robinson et al, 2004;Sullivan et al, 2005;Stratos et al, 2006), our overall results for levels 1 and 2 were very positive in terms of course evaluations and learning achievements (Tables 2, 3).…”

“…Indeed, it was necessary to focus on the teaching skills of trainers to enhance the communications skills and psychosocial sensitivity of the physicians, nurses, and other professionals who receive such training and provide end-of-life care to patients and their families. In response to the need to develop teaching skills, several train-the-trainers programs, such as the Education for Physicians on End-of-Life Care Project (EPEC) (Robinson et al, 2004), the Palliative Care Education and Practice at Harvard Medical School (PCEP) (Sullivan et al, 2005), the Stanford Faculty Development Center's (SFDC) End-of-Life Care Program (Stratos et al, 2006), and the End-of-Life Nursing Education Consortium (ELNEC), have been successfully implemented (Kelly et al, 2011). These programs have similar goals: to teach the core content of end-of-life care as well as to help the medical faculty develop effective teaching skills using a train-thetrainer strategy.…”

“…We adopted a train-the-trainers approach to disseminate this program across Korea. This approach has been used widely in medical education to improve faculty teaching and disseminate educational programs (Sullivan et al, 2005;Stratos et al, 2006;Diesel et al, 2011;Pien et al, 2011;Lee et al, 2012). In the present study, we assessed the effect of the national train-the-trainers program for HPC experts (TTHPC) in Korea using Kirkpatrick's evaluation model.…”

Evaluation of a Train-the-Trainer Program for Tobacco Cessation

“…[2][3][4][5][6] Indeed, surveys of practicing clinicians suggest few healthcare providers have received comprehensive training for providing tobacco cessation counseling to patients. [7][8][9][10] The train-the-trainer model has been increasingly used in the education of students in the healthcare professions [11][12][13][14][15][16] and for continuing education of licensed clinicians. [17][18][19][20] The approach appears to be useful in meeting the educational needs of the health care system by increasing the knowledge and skills of providers.…”

“…Furthermore, staff development programs may improve employee retention. 17 Recent evaluations of physician train-thetrainer programs in preventive medicine, 11 evidencebased medicine, 12 managed care, 13 and end-of-life care 14 have reported significant improvements in faculty participants' knowledge and self-assessed ability to teach these content areas.…”