Experiences with a national team-based learning program for advance care planning in pediatric palliative care

Marijanne Engel*, Jurrianne C. Fahner, Marije P. Hennus, Marie-José Brounen, Carine van Capelle, Marinka A.R. de Groot, Marion Hermans-Peters, Suzanne C. Hofman, Cindy Joosen, Sarmila Lalbahadoersing-Jharap, Sofie Maebe, Erna M.C. Michiels, Suzanna Miedema, Martine F Raphael, Jolanda H. Schieving, Willemien de Weerd, MC Kars

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background
Advance Care Planning (ACP) enables patients and relatives to define and share values, goals and preferences for future medical treatment and care. The IMplementing Pediatric Advance Care Planning Toolkit (IMPACT), developed in the Netherlands, is a method for conducting ACP in pediatric palliative care. Healthcare professionals who were trained to use IMPACT, indicated their need for ongoing support to practice ACP communication skills optimally over time. Therefore, we developed a team-based learning program aimed at teaching participants how to transfer knowledge on ACP, continue practicing ACP communication skills and reflect on ACP conversations within their own team context. The aim of this study was to evaluate the program’s transfer of knowledge as well as the professionals’ experience and team reflection on ACP.
Methods
A one-day IMPACT train-the-trainer course was developed and a selection of healthcare professionals (facilitators) from pediatric palliative care teams (PPCTs) from all seven Dutch university hospitals and the specialized Center for Pediatric Oncology were invited to participate. Hereafter, facilitators were asked to transfer their course-acquired knowledge to their team members (learners) by organizing two coaching-on-the-job sessions. A mixed-methods design, combining questionnaires and field notes, was used to evaluate the level of knowledge transfer and team reflection achieved.
Results
Eighteen healthcare professionals in the role of facilitator participated in the train-the-trainer course. In seven PPCTs one (n=3) or two (n=4) coaching-on-the-job session(s) took place, attended by 29 and 17 learners, respectively. In the questionnaires, 11 facilitators indicated that they had to some extent transferred acquired knowledge to their team members as intended. Sixteen out of 21 learners who participated in at least one coaching-on-the-job session, reported (somewhat) increased self-confidence for conducting ACP conversations. The reported main strength of the program was practicing with/learning from colleagues whereas dealing with workload and variation in existing ACP skills within PPCTs need more attention.
Conclusions
The newly developed team-based learning program resulted in intended transfer of knowledge and methodical reflection on ACP in coaching-on-the-job sessions in most participating PPCTs. Planning coaching-on-the-job sessions regarding ACP in pediatric palliative care with multiple healthcare professionals is challenging and needs more emphasis in the training.
Original languageEnglish
Article number196
Number of pages11
JournalBMC Palliative care
Volume23
Issue number1
DOIs
Publication statusPublished - 3 Aug 2024

Keywords

  • Advance care planning
  • Communication training
  • Evaluation study
  • Healthcare professionals
  • Implementation
  • Knowledge
  • Learning program
  • Palliative care
  • Pediatric care

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