A feasibility study of an Evidence-informed, Competency-based, Accredited, Compassion Training (EnACT) program

OBJECTIVES: This study assessed the feasibility and impact of an Evidence-informed, Competency-based, Accredited, Compassion Training (EnACT) program on both healthcare providers' confidence and competence in compassion, professional fulfillment, and burnout; and patients' experiences of compassion. DESIGN: A two arm non-randomized controlled feasibility trial to evaluate the feasibility and impact of the program over a nine-month period. SETTINGS AND PARTICIPANTS: The study was conducted between July 2023 and August 2024 in two long term care settings and two hospices in Canada. A total of 163 eligible healthcare providers participated, and 634 patients completed the Sinclair Compassion Questionnaire (SCQ). RESULTS: All feasibility targets were met, apart from the proportion of patients who skipped any one item on the SCQ being slightly higher than predicted. In addition to high sustained levels of learner satisfaction, professional fulfillment significantly increased in the intervention group. Compassion confidence also improved significantly in the intervention group immediately post-training and remained high nine-months post-training, with a similar, albeit weaker, trend observed for compassion competence. Notably, one-month post-training, patients being cared for by participants in the intervention group, reported a statistically significant increase in experiences of compassion in comparison to patients in the control group. These results and subsequent power analysis suggest that a full randomized controlled trial is feasible. CONCLUSIONS: Compassion has been long regarded as a key component of quality care that patients want and healthcare providers desire to provide. Despite its reputed importance, healthcare providers are given limited training and healthcare organizations are provided little guidance on how to cultivate compassion in their organizational cultures. The EnACT program addresses existing limitations associated with compassion training programs, while also positively impacting both learner outcomes associated with compassion and also importantly their patients' experiences of compassion.