The initial validation of an Evidence-informed, competency-based, Applied Compassion Training (EnACT) program: a multimethod study

INTRODUCTION

Compassion is positively associated with improved patient outcomes, quality care ratings, and healthcare provider wellbeing. Supporting and cultivating healthcare providers' compassion through robust and meaningful educational initiatives has been impeded by a lack of conceptual clarity, inadequate content coverage across the domains of compassion, and the lack of validated evaluation tools. The EnACT program aims to address these gaps through an Evidence-informed, competency-based, Applied, Compassion Training program delivered to healthcare providers working in various clinical settings. In this study, we describe the development and initial validation of the program, which will inform and be further evaluated in a forthcoming Randomised Controlled feasibility Trial (RCfT).

METHOD

A multimethod design was used to explore learner needs, experiences, and outcomes associated with the program. Pre- and post-training surveys and qualitative interviews (1 month post training) were conducted among twenty-six healthcare provider learners working in acute care and hospice. Quantitative measures assessed professional fulfillment/burnout, self-confidence in providing compassion, learner satisfaction, and compassion competence. Qualitative interviews explored learners' experiences of the program, integration of learnings into their professional practice, and program recommendations.

RESULTS

Learners exhibited relatively high self-assessed compassion competence and professional fulfillment pre-training and low levels of burnout. Post-training, learners demonstrated high levels of compassion confidence and satisfaction with the training program. Despite high levels of reported compassion competence pre-training, a statistically significant increase in post-training compassion competence was noted. Thematic analysis identified five key themes associated with learners' overall experience of the training day and integration of the learnings and resources into their professional practice: (1) A beginner's mind: Learner baseline attitudes and assumptions about the necessity and feasibility of compassion training; (2) Learners' experiences of the training program; (3) Learner outcomes: integrating theory into practice; (4) Creating cultures of compassion; and (5) Learner feedback.

CONCLUSION

Findings suggest that the EnACT program is a feasible, rigorous, and effective training program for enhancing healthcare provider compassion. Its evidence-based, patient-informed, clinically relevant content; interactive in class exercises; learner toolkit; along with its contextualized approach aimed at improving the clinical culture learners practice holds promise for sustaining learnings and clinical impact over time-which will be further evaluated in a Randomized Controlled feasibility Trial (RCfT).

Promotion of professional quality of life through reducing fears of compassion and compassion fatigue: Application of the Compassionate Mind Model to Specialist Community Public Health Nurses (Health Visiting) training

AIMS AND OBJECTIVES

To identify whether a Compassionate Mind Model-based curriculum reduces students' perceived fears of compassion and improves their professional well-being.

BACKGROUND

Enabling compassion is mandatory within nurse education but evidencing it is challenging. Research suggests that application of the Compassionate Mind Model might reduce students' fears of compassion and also decrease compassion fatigue. This study reports outcomes of a post-registration curriculum based on that model for training Specialist Community Public Health Nurses (Health Visiting).

DESIGN

A quantitative, prospective evaluation of a 12-month training course for Health Visiting students. Reporting was guided by the STROBE checklist for observational studies.

METHODS

Fears of compassion scales were applied at course start (time 1), mid-point (time 2; +6 months) and end (time 3; +12 months) to evaluate fears of compassion of 26 post-registration student Health Visitors (81% of course cohort) who provided data at all three points. The Professional Quality of Life tool was administered simultaneously to evaluate compassion satisfaction and burnout/secondary traumatic stress (compassion fatigue).

RESULTS

Between time 1 and time 3, mean fears of compassion scores decreased by 16.6-48.5% (repeated measures analysis of variance); mid-point scores were intermediary. At time 3, compassion satisfaction had increased slightly (+4.1%), negatively correlated with fears of compassion for self (r = -0.602; p = .001; n = 26) and fears of receiving compassion from others (r = -0.568; p = .002; n = 26). Burnout score decreased by 18.7%, correlated positively with fear of compassion for self (r = 0.493; p = .011; n = 26) and fear of receiving compassion from others (r = 0.615; p = .001; n = 26). Secondary traumatic stress score decreased by 16.5% but was not correlated with any fear of compassion.

CONCLUSION

Findings suggest that application of the Compassionate Mind Model might reduce practitioners' fears of compassion linked to a decrease in risk of compassion fatigue.

RELEVANCE TO CLINICAL PRACTICE

The Compassionate Mind Model could provide an effective vehicle to promote compassion and nurse well-being.

Clustering clinical learning environment and mentoring perceptions of nursing and midwifery students: A cross-sectional study

AIMS

This study aimed to explore nursing and midwifery students' evaluation of the clinical learning environment and mentoring and to identify distinct student profiles relating to their perceptions.

DESIGN

This study employed a cross-sectional design.

SETTINGS

The study population included nursing and midwifery students in a university hospital in Finland.

PARTICIPANTS

All nursing and midwifery students who completed their clinical placement were invited to take part in the study in the academic year 2017-2018.

METHODS

The data (N = 2,609) were gathered through an online survey using the Clinical Learning Environment, Supervision and Nurse Teacher scale. The data were analysed using a K-mean cluster algorithm to identify nursing and midwifery students' profiles.

RESULTS

The findings from this study indicate four distinct profiles (A, B, C, & D) of nursing and midwifery students in relation to the clinical learning environment and mentoring. Profile A (N = 1,352) students evaluated their clinical learning environment and mentoring to the highest level (mean varied from 9.44-8.38); and Profile D (N = 151)- to the lowest (mean varied from 5.93-4.00).

CONCLUSION

The findings highlight that nursing and midwifery students evaluate their clinical learning environment and mentoring more highly when: they have a named mentor, student and mentor discuss learning goals, there is a final assessment in clinical learning, the mentor's guidance skills support student learning, the clinical learning supports the student's professional development and pre-clinical teaching in an educational institution supports learning in the clinical placement.

IMPACT

Clinical learning plays an important role in nurse and midwifery education. Mentoring of clinical practice was shown to have a great influence on students' perceptions of their success in clinical learning. We suggest that clinical practice should be strengthened by the building of collaboration between nursing teachers and registered nurses.