Training program content
Our pilot PCOR training program consisted of four separate core competencies: (1) Understand the principles of research; (2) Understand the science of PCOR; (3) Participate in and maintain a PCOR team; (4) Design and implement a PCOR study. Each core competency served as a separate session title and within each competency we listed learning objectives, training format, presenters/facilitators and the learner group/audience for which the session was intended (see Appendix 2). Our first training was intended for patients/caregivers only (Research 101), and included a 25-min asynchronous, self-directed learning seminar intended to be viewed before the subsequent interactive PCOR sessions. The remaining three training programs were synchronous, interactive training sessions, lasting approximately 1.5 h each. Two of these sessions included both learner groups (patients/caregivers and researchers/providers) together (PCOR 101 and PCOR Team Dynamics) and one session (PCOR Study Design) was for researchers/healthcare providers only. The pilot training sessions can be downloaded here: familymedicine.uw.edu/pcor-guide/.
Training program evaluation
Training program participants included 28 patients and caregivers, and 31 researchers and providers. Several participants attended more than a single PCOR session. Detailed training program participant characteristics, including type of participant, job title, and attendees per session are reported in Table 1.
Overall, participants significantly improved self-assessed PCOR knowledge. The median Likert scale responses post-training for training session 1 and a test of the difference between knowledge perception questions administered before and after training sessions 2, 3, and 4 are presented in Table 2.
After Training 1 (Research 101), we found the majority of patients/caregivers reported being able to describe the different types of research methods (15/17, 88%), terminology (14/17, 82%), and modes of dissemination used in PCOR (17/17, 100%).
After Training 2 (PCOR 101), we found a significant difference in change of PCOR knowledge related to engagement levels compared to before among patients/caregivers and CF researchers/providers, (p values = 0.008 and 0.031, respectively). Following the session, patients/caregivers reported being significantly better able to identify barriers and enablers to adopting PCOR compared to pre-training (p = 0.016), whereas CF researchers/providers reported being significantly better able to describe and provide examples of the core principles of PCOR (p = 0.017).
During Training 3 (PCOR Team Dynamics), patients/caregivers significantly improved their PCOR knowledge in every aspect of the training except knowing how confidentiality of patient partners are maintained on PCOR teams. In contrast, we found no reported significant PCOR knowledge changes among CF researchers/providers. After this session, patients/caregivers reported being significantly better able to describe elements of an effective PCOR team (p = 0.039), how to be an active participant throughout the research process (p = 0.012), how to identify barriers to successfully functioning PCOR teams (p = 0.021).
In Training 4 (PCOR Study Design for CF Researchers/Providers only), participants reported significant improvement of their PCOR knowledge in every aspect of the training, including how to identify patients and caregivers to participate as partners in research, formulate research questions from patient-driven priorities, articulate successful components of an engagement plan in grant applications, and describe the patient partner role at every stage of the research project (p-values = 0.039, 0.039, 0.006, 0.001).
Confidence with engaging partners in PCOR
Confidence was only solicited in surveys related to Training 2–4. The median confidence score of patient/caregiver participants attending training sessions 2 (PCOR 101) or 3 (PCOR Team Dynamics) to engage as a partner in research was a “4” (fairly confident), which did not change significantly after either training. Similarly, the median confidence score of CF researchers/providers attending training sessions 2, 3 or 4 (PCOR Study Design) did not change significantly: self-rated confidence to engage PwCF in research before each training was either “3” (neutral) or “4” (fairly confident), and after each training was “4” (fairly confident).
Training session satisfaction
Overall, both learner groups were satisfied with the format of each training session (Fig. 3). The highest proportion of participants from either the patient or researcher/provider group who reported being very satisfied with the training occurred with Training 3 (PCOR team dynamics) compared with the other training sessions.
Training satisfaction: open-ended questions
Training 1 (Research 101) The most common beneficial aspects participants noted was learning about research terminology, the grant submission process, how to design research questions, and the difference between types of research studies (e.g., quantitative vs qualitative and retrospective vs prospective). Most participants appreciated the inclusion of multiple speakers, including people with CF and the incorporation of visuals.
Training 2 (PCOR 101) Most participants liked the interaction between patients, caregivers, researchers and healthcare providers and the fact that the learners were taught together. Some participants reported not liking required participation in the interactive portions of the training, while others thought the breakout sessions were too small and too short. One person suggested having facilitators participate in each group to help move the conversation along.
Training 3 (PCOR Team Dynamics) This training included two case scenarios related to: (1) creating a respectful space for collective sharing, and (2) building and maintaining trust. Within each scenario, participants were asked to identify barriers to a successfully functioning PCOR team and articulate potential solutions to address those barriers. All participants commented that they enjoyed the discussion of both case scenarios, and thought they clearly illustrated potential challenges PCOR teams face. Participants also liked how facilitators engaged to advance the discussions. For example, one researcher/provider participant noted that all participants were “encouraged to speak”. Participants suggested including more role playing for this training.
Training 4 (PCOR Study Design) Participants favorably rated the video conferencing format and thought the session was easy to join. Several suggestions for improvement included: Offering closed captioning versions of the presentation for viewing in different languages (including English for Deaf viewers); shorten the panel discussion and bring back the interactive breakout session format; provide more specific examples of how including patients or caregivers on the research team improves the quality and relevance of research; include example documents, such as a patient partner biographies and a list of potential patient partner roles; include more discussion of ways to include a diverse representation of patients on the research team.