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Process-evaluation and outcome-evaluation of a training programme for healthcare professionals in oncology to enhance their competencies in caring for patients with minor children: a study protocol for a randomised controlled pilot study.

ABSTRACT: INTRODUCTION:Patients with cancer having minor children experience particular burden and strains. Being patient and parent at the same time is associated with specific needs of support. Therefore, the communication of child-related and family-related issues plays an important role in patient care. This study aims at testing the feasibility of a training to improve the situation of patients with cancer having minor children and their families by enhancing the competencies of healthcare professionals (HCPs, eg, physicians, nurses, psychologists) in caring for patients with cancer having minor children. Moreover, the study aims at testing the study design and outcomes of the evaluation concept and preliminary effects of the training. METHODS AND ANALYSIS:We will conduct a randomised controlled pilot trial with three arms (face-to-face training versus web-based training versus waitlist control group) to investigate the study aims. Primary outcome will be the competency to approach child-related and family-related topics in patients with cancer measured using comprehensive case vignettes. Secondary outcomes will be communication and attitudes regarding child-related and family-related topics and self-efficacy in clinical communication skills. Outcomes will be assessed prior to the training and after the training as well as 3 months after the training. Data will be analysed using descriptive analyses, group comparisons and linear mixed models. ETHICS AND DISSEMINATION:The study was approved by the Local Psychological Ethics Committee of the Center for Psychosocial Medicine of the University Medical Center Hamburg-Eppendorf (LPEK-001). At the end of the study, a web-based training and a face-to-face training intervention to enhance the competencies of HCPs in caring for patients with cancer having minor children will have been systematically developed and the study design and evaluation concept will have been evaluated. The results of the study will be disseminated through peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER:DRKS00015794.

SUBMITTER: Inhestern L

PROVIDER: S-EPMC6797360 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Process-evaluation and outcome-evaluation of a training programme for healthcare professionals in oncology to enhance their competencies in caring for patients with minor children: a study protocol for a randomised controlled pilot study.

Inhestern Laura L Frerichs Wiebke W Johannsen Lene Marie LM Bergelt Corinna C

BMJ open 20191014 10

<h4>Introduction</h4>Patients with cancer having minor children experience particular burden and strains. Being patient and parent at the same time is associated with specific needs of support. Therefore, the communication of child-related and family-related issues plays an important role in patient care. This study aims at testing the feasibility of a training to improve the situation of patients with cancer having minor children and their families by enhancing the competencies of healthcare pr ...[more]

PMID: 31615803

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Project description:BACKGROUND: While evaluation is, in theory, a component of training programmes in health planning, training needs in this area remain significant. Improving health systems necessarily calls for having more professionals who are skilled in evaluation. Thus, the Université de Ouagadougou (Burkina Faso) and the Université de Montréal (Canada) have partnered to establish, in Burkina Faso, a master's-degree programme in population and health with a course in programme evaluation. This article describes the four-week (150-hour) course taken by two cohorts (2005-2006/2006-2007) of health professionals from 11 francophone African countries. We discuss how the course came to be, its content, its teaching processes and the master's programme results for students. METHODS: The conceptual framework was adapted from Kirkpatrick's (1996) four-level evaluation model: reaction, learning, behaviour, results. Reaction was evaluated based on a standardized questionnaire for all the master's courses and lessons. Learning and behaviour competences were assessed by means of a questionnaire (pretest/post-test, one year after) adapted from the work of Stevahn L, King JA, Ghere G, Minnema J: Establishing Essential Competencies for Program Evaluators. Am J Eval 2005, 26(1):43-59. Master's programme effects were tested by comparing the difference in mean scores between times (before, after, one year after) using pretest/post-test designs. Paired sample tests were used to compare mean scores. RESULTS: The teaching is skills-based, interactive and participative. Students of the first cohort gave the evaluation course the highest score (4.4/5) for overall satisfaction among the 16 courses (3.4-4.4) in the master's programme. What they most appreciated was that the forms of evaluation were well adapted to the content and format of the learning activities. By the end of the master's programme, both cohorts of students considered that they had greatly improved their mastery of the 60 competences (p<0.001). This level was maintained one year after completing the master's degree, except for reflective practice (p<0.05). Those who had carried out an evaluation in the intervening 12 months reported a negative gap between their declared mastery and their actual application. However, this is only statistically significant for reflective practice (p < 0.05). CONCLUSION: This study shows the importance of integrating summative evaluation into the learning process. Skills-based teaching is much appreciated and well-adapted. Creating a master's programme in population and health in Africa and providing training in evaluation to high-level health professionals from many countries augurs well for scaling up the practice of evaluation in African health systems.

Project description:BackgroundMost oncology trainees are not taught about the needs of older patients, who make up the majority of patients with cancer. Training of health care providers is critical to improve the care of older adults with cancer. There is no consensus about which geriatric oncology (GO) competencies are important for medical oncology trainees. Our objective was to identify GO competencies medical oncology trainees should acquire during training.Materials and methodsA modified Delphi consensus of experts in oncology medical education and GO was conducted. Experts categorized at what training stage proposed competencies should be attained: internal medicine, oncology, or GO training. Consensus was obtained if two thirds of experts agreed on the training stage at which the competency should be attained.ResultsA total of 78 potential competencies were identified, of which 35 (44.9%) proposed competencies were felt to be appropriate to be acquired during oncology training. The majority of the identified competencies pertained to prescribing of systemic therapy (n = 12) and psychosocial and supportive care (n = 13). No competencies related to geriatric assessment were identified for acquisition during oncology training.ConclusionExperts in oncology education and geriatric oncology agreed upon a set of GO competencies appropriate for oncology trainees. These results provide the foundation for developing a GO curriculum for medical oncology trainees and will hopefully lead to better care of older adults with cancer.Implications for practiceThe aging population will drive the projected rise in cancer incidence. Although aging patients make up the majority of patients diagnosed with cancer, oncologists rarely receive training on how to care for them. Training of health care providers is critical to improving the care of older adults with cancer. The results of this study will help form the foundation of developing a geriatric oncology curriculum for medical oncology trainees.

Project description:IntroductionThe Perioperative Quality Improvement Programme (PQIP) is designed to measure complications after major elective surgery and improve these through feedback of data to clinicians. Previous research suggests that despite the significant resources which go into collecting data for national clinical audits, the information they contain is not always used effectively to improve local services.Methods and analysisWe will conduct a formative process evaluation of PQIP comprising a multisited qualitative study to analyse PQIP's programme theory, barriers, facilitators and wider contextual factors that influence implementation. The research will be carried out with the PQIP project team and six National Health Service (NHS) Trusts in England, selected according to geographical location, type of hospital, size and level of engagement with PQIP. We will include one Trust which has not expressed interest in the PQIP for comparison and to explore the role of secular trend in any changes in practice. We will use semi-structured interviews (up to 144 in Trusts and 12 with the project team), non-participant observations (up to 150 ?hours) and documentary analysis. We will track the lifecycle of perioperative data, exploring the transformations it undergoes from creation to use. We will use framework analysis with categories both from our research questions and from themes emerging from the data.Ethics and disseminationEthical approval has been granted from the University College London Research Ethics Committee (ref 10375/001). Permissions to conduct research at NHS Trusts have been granted by local Research and Development offices in coordination with the Health Research Authority. We will follow guidelines for data security, confidentiality and information governance. Findings will be shared at regular time points with the PQIP project team to inform the implementation of the programme, and with participating NHS Trusts to help them reflect on how they currently use data for improvement of perioperative services.

Project description:BackgroundGirls Active is a physical activity programme, delivered in UK secondary schools, with the aim of increasing moderate-to-vigorous physical activity (MVPA) in girls aged 11-14 years. This study presents the process evaluation as part of a 14-month cluster randomised controlled trial designed to evaluate the effectiveness of the Girls Active programme and which showed no difference in the primary outcome (MVPA at 14 months) between intervention and control arms.MethodsQuantitative and qualitative data were collected from intervention schools over the course of the 14 month trial. Feedback forms and attendance records were completed at the end of all teacher and peer leader training and review days. At 7- and 14-months, semi-structured interviews were conducted with the lead Girls Active teacher in all intervention schools (n = 10) and staff from the intervention provider (n = 4) and hub school (n = 1). At 14 months, separate focus groups with peer leaders (n = 8 schools), girls who participated in the evaluation component of the trial (n = 8 schools), and a sample of boys (n = 6 schools) were conducted. All participants in the intervention schools were asked to complete an exit survey at 14 months. Teachers (intervention and control) completed a school environment questionnaire at baseline, 7- and 14-months.ResultsThe Girls Active programme, i.e., the training and resources, appeared to be well received by teachers and pupils. Factors that may have contributed to the lack of effectiveness include: some initial uncertainty by teachers as to what to do following the initial training, a predominant focus on support activities (e.g., gathering opinions) rather than actual physical activity provision, and school-level constraints that impeded implementation.ConclusionsGirls Active and what it was trying to achieve was valued by schools. The programme could be improved by providing greater guidance to teachers throughout, the setting of timelines, and providing formal training to peer leaders.Trial registrationISRCTN, ISRCTN10688342 . Registered 12 January 2015.

Project description:IntroductionCaring professions attend to the health, educational and social needs of society rather than its material needs. Caring professionals are a vital part of the world's response to COVID-19, yet the global pandemic and its aftermath have significantly changed the ways in which care is provided. The rapid pivot to remote care, where the essential caring cues and opportunities are not as readily available, has put unprecedented pressure on caring professions. There is currently a lack of clear understanding and accepted standards for teaching caring profession students how to provide care remotely. The objective of this systematic review is to identify and assess the ways in which educators can integrate online learning opportunities to help students develop effective caring practices and translate these into today's remote and virtual care environments.Methods and analysisThis systematic review will consider diverse quantitative, qualitative and mixed-methods studies of innovative online education initiatives and required technology for caring profession education. Articles will be retrieved from academic databases and limited to articles reporting primary data and published in English within the last 10 years. Data extraction procedures will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. The methodological quality of all studies will be assessed using the Effective Public Health Practice Project Quality Assessment Tool and/or the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Study characteristics will be tabulated and narratively synthesised to integrate and explore relationships within the data.Ethics and disseminationNo ethics approval is required to conduct this review. Review findings will be disseminated through peer-reviewed publications, conference presentations and be used to inform and guide caring profession education policy, practice and research agendas with the goal of improving education for caring profession students, and care for the patients, clients and learners they serve.

Project description:BackgroundThe Nurses in the Lead (NitL) programme consists of a systematic approach and training to 1) empower community nurses in implementing evidence, targeted at encouraging functional activities of older adults, and 2) train community nurses in enabling team members to change their practice. This article aims to describe the process evaluation of NitL.MethodsA mixed-methods formative process evaluation with a predominantly qualitative approach was conducted. Qualitative data were collected by interviews with community nurses (n = 7), focus groups with team members (n = 31), and reviewing seven implementation plans and 28 patient records. Quantitative data were collected among community nurses and team members (N = 90) using a questionnaire to assess barriers in encouraging functional activities and attendance lists. Data analysis was carried out through descriptive statistics and content analysis.ResultsNitL was largely executed according to plan. Points of attention were the use and value of the background theory within the training, completion of implementation plans, and reporting in patient records by community nurses. Inhibiting factors for showing leadership and encouraging functional activities were a lack of time and a high complexity of care; facilitating factors were structure and clear communication within teams. Nurses considered the systematic approach useful and the training educational for their role. Most team members considered NitL practical and were satisfied with the coaching provided by community nurses. To optimise NitL, community nurses recommended providing the training first and extending the training. The team members recommended continuing clinical lessons, which were an implementation strategy from the community nurses.ConclusionsNitL was largely executed as planned, and appears worthy of further application in community care practice. However, adaptations are recommended to make NitL more promising in practice in empowering community nurse leadership in implementing evidence.

Project description:Background: Neonatal mortality rates remain high in Sub-Saharan African countries. Improving the newborn resuscitation skills of healthcare professionals is important in addressing this challenge. The aim of this study was to evaluate a neonatal resuscitation training programme delivered over a two-year period for healthcare professionals in Zanzibar, Tanzania. Methods: A pre- and post-intervention study was designed. We delivered neonatal resuscitation training over a 2-day period in 2017 and 2 days of refresher training in 2018. Knowledge was evaluated by a self-designed survey (11 items with a total score of 22) before and after the two training periods, and skills were evaluated by a skills checklist (six domains with 25 items with a total score of 50) completed by the trainers based on their observations. Statistical analysis included differences in the knowledge and skills scores before and after the training sessions and between the two periods. Results: A total of 23 healthcare professionals participated and completed both neonatal resuscitation training sessions. The knowledge mean scores before and after the training in 2017 increased from 9.60 to 13.60 (95% CI: -5.900; -2.099, p < 0.001), and in 2018, the scores increased from 10.80 to 15.44 (95% CI: -6.062; -3.217, p < 0.001). The mean knowledge scores post-training over time were 13.60 in 2017 and 15.44 in 2018 (95% CI: -3.489; 0.190, p = 0.030). The resuscitation skills performance between the two time periods increased from a mean of 32.26 (SD = 2.35) to a mean of 42.43 (SD = 1.73) (95% CI: -11.402; -8.945, p < 0.001). Conclusion: The neonatal resuscitation training programme increased the theoretical knowledge and resuscitation skills before and after the two training sessions and over time after a 9-month period. Continuous neonatal resuscitation training based on the local needs in resource-limited countries is essential to provide confidence in healthcare professionals to initiate resuscitation and to improve newborn outcomes.

Project description:BackgroundVisual impairment is a global public health problem, with an estimated 285 million affected globally, of which 43% are due to refractive error. A lack of specialist eye care in low and middle-income countries indicates a new model of care would support a task-shifting model and address this urgent need. We describe the features and results of the process evaluation of a national primary eye care (PEC) programme in Rwanda.MethodsWe used the Medical Research Council process evaluation framework to examine the implementation of the PEC programme, and to determine enablers and challenges to implementation. The process evaluation uses a mixed methods approach, drawing on results from several sources including a survey of 574 attendees at 50 PEC clinics, structured clinical observations of 30 PEC nurses, in-depth interviews with 19 key stakeholders, documentary review and a participatory process evaluation workshop with key stakeholders to review collated evidence and contextualize the results.ResultsStructured clinical assessment indicated that the PEC provided is consistent with the PEC curriculum, with over 90% of the clinical examination processes conducted correctly. In 4 years, programme monitoring data showed that nearly a million PEC eye examinations had been conducted in every health centre in Rwanda, with 2707 nurses trained. The development of the eye health system was an important enabler in the implementation of PEC, where political support allowed key developments such as inclusion of eye-drops on the essential medicines list, the inclusion of PEC on insurance benefits, the integration of PEC indicators on the health management information systems and integration of the PEC curriculum into the general nursing school curriculum. Challenges included high turnover of primary care nurses, lack of clarity and communication on the future funding of the programme, competing priorities for the health sector and sustained supervision to assure quality of care.ConclusionsA model of a national primary eye care programme is presented, with service delivery to all areas in Rwanda. Key learning from this evaluation is the importance of strengthening the eye health care system, together with a strong focus on training primary care nurses using a PEC curriculum.

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Process-evaluation and outcome-evaluation of a training programme for healthcare professionals in oncology to enhance their competencies in caring for patients with minor children: a study protocol for a randomised controlled pilot study.

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Process-evaluation and outcome-evaluation of a training programme for healthcare professionals in oncology to enhance their competencies in caring for patients with minor children: a study protocol for a randomised controlled pilot study.

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