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Chen HW, Cheng SF, Hsiung Y, Chuang YH, Liu TY, Kuo CL. Training perinatal nurses in palliative communication by using scenario-based simulation: A quasi-experimental study. Nurse Educ Pract 2024; 75:103885. [PMID: 38232677 DOI: 10.1016/j.nepr.2024.103885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/25/2023] [Accepted: 12/11/2023] [Indexed: 01/19/2024]
Abstract
AIM This study aimed to assess the impact of two educational modules on enhancing the communication confidence, competence and performance of perinatal nurses in the context of palliative care. BACKGROUND Concerns have arisen regarding the preparedness of perinatal nurses in delivering palliative care, especially in terms of deficiencies in communication skills and negative attitudes toward making life-support decisions for parents facing neonates with terminal conditions. Bridging this gap necessitates improved perinatal palliative care education for healthcare providers. Research has shown that simulation-based teaching effectively enhances procedural competence, communication skills and confidence among healthcare professionals. However, comprehensive curricula focusing on perinatal palliative communication remain limited. DESIGN This study used a quasi-experimental design employing a two-group repeated measure approach. It involved a purposive sample of 79 perinatal nurses from a hospital in northern Taiwan. METHODS A palliative communication course specifically designed for registered nurses in perinatal units was developed. Participants were allocated to either the experimental group (Scenario-Based Simulation, SBS) or the control group (traditional didactic lecture). Communication confidence and competence were assessed before and immediately after the course through structured questionnaires. Learning satisfaction was collected post-intervention and participants underwent performance evaluation by standardized parents one week later. RESULTS A significant training gap in palliative care exists among nurses in OB/GYN wards, delivery rooms and neonatal critical care units, highlighting the need for continuing education. All 79 participants completed the training course. Following the intervention, nurses in the SBS group (n=39) exhibited significant improvements in self-reported confidence (p <0.05), competence (p <0.01) and performance (p <0.001) in neonatal palliative communication compared with the traditional didactic lecture group (n=40). The SBS group also received higher satisfaction ratings from nurse learners (p <0.001). CONCLUSIONS The research findings support scenario-based simulation as a more effective educational approach compared with traditional didactic lectures for enhancing communication confidence and competence. These results were further reinforced by evaluation from standardized patients, highlighting the value of direct feedback in enhancing nurses' performance. Tailoring SBS designs to diverse nursing contexts and incorporating a flipped approach can further enrich the overall learning experience. Given its high effectiveness and positive reception, we recommend integrating this educational module into palliative care training programs for perinatal nurses.
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Affiliation(s)
- Hsiao-Wei Chen
- Department of Nursing, Taipei City Hospital, Heping Fuyou Branch, No. 33, Section 2, Zhonghua Road, Taipei 100, Taiwan.
| | - Su-Fen Cheng
- Department of Allied Health Education & Digital Learning, National Taipei University of Nursing and Health Sciences, No. 365, Ming-Te Road, Peitou District, Taipei 112, Taiwan.
| | - Yvonne Hsiung
- Department of Nursing, MacKay Medical College, No.46, Section 3, Zhongzheng Rd., Sanzhi Dist., New Taipei City 252, Taiwan.
| | - Yeu-Hui Chuang
- School of Nursing, College of Nursing, Taipei Medical University; Department of Nursing, Wan Fang Hospital, Taipei Medical University; Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, 111 Xinglong Rd, Sec. 3. Wenshan District, Taipei 11696, Taiwan.
| | - Tsui-Yao Liu
- Department of Nursing, Taipei City Hospital, Yangming Branch, No. 105, Yusheng Street, Shilin District, Taipei 111, Taiwan.
| | - Chien-Lin Kuo
- Department of Allied Health Education & Digital Learning, National Taipei University of Nursing and Health Sciences, No. 365, Ming-Te Road, Peitou District, Taipei 112, Taiwan.
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Skedsmo K, Bingen HM, Hofsø K, Steindal SA, Hagelin CL, Hilderson D, Nes AAG, Smis D, Stenseth HV, Olaussen C. Postgraduate nursing students' experiences with simulation-based learning in palliative care education: A qualitative study. Nurse Educ Pract 2023; 73:103832. [PMID: 37948917 DOI: 10.1016/j.nepr.2023.103832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/06/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
AIM The aim of this study was to explore postgraduate palliative care nursing students' experiences with simulation-based learning focusing on communication skills, as a learning method in palliative care education. BACKGROUND Communication is one of several important competencies in palliative care and found to be challenging. Developing appropriate communication skills in palliative care requires education and practice. To provide postgraduate palliative care nursing students with the required knowledge and experience, practical and active learning approaches, such as simulation-based learning, can be applied. Several studies have explored undergraduate nursing students' experiences with simulation-based learning in palliative care. However, to our knowledge no studies have explored postgraduate palliative care nursing students` experiences with simulation-based learning focusing on communication skills in palliative care education. DESIGN An exploratory descriptive design. METHODS A qualitative method was employed. Three focus group interviews were conducted in May 2022 using videoconferencing (Zoom) with 11 postgraduate palliative care nursing students, eight of whom wrote reflective notes. Data were analysed using systematic text condensation. RESULTS Three categories were identified in the data analysis: 1) from uncertain expectations to the real experience of simulation-based learning; 2) being a skilled professional in everyday life versus being observed in the scenarios; and 3) the balance between self-confidence and challenges in experiencing professional development and mastery. CONCLUSIONS Postgraduate palliative care nursing students seemed to experience anxiety towards simulation-based learning in palliative care education, as well as variable expectations for the approach. This could be due to their unfamiliarity with the learning method. The need for repetition was underlined and the students indicated that they would like to be able to participate in several simulation sessions to familiarise themselves with the approach. The contrast between being a skilled professional in everyday life and the pressure of being observed and judged in the scenarios was an important finding. Students outlined the desire to feel safe, but also highlighted the importance of being challenged to experience professional development and enhanced mastery. Generally, the findings indicate that academic and psychological safety should be a focus during simulation-based learning and instructors should understand that students may have varied learning strategies, divergent learning experiences and shifting beliefs in their own competencies.
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Affiliation(s)
| | | | - Kristin Hofsø
- Lovisenberg Diaconal University College, Oslo, Norway; Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo, University Hospital, Oslo, Norway
| | - Simen A Steindal
- Institute of nursing, Faculty of Health Studies, VID Specialized University, Oslo, Norway; Lovisenberg Diaconal University College, Oslo, Norway
| | - Carina Lundh Hagelin
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
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Chang KKP, Chan EA, Chung BPM. A new pedagogical approach to enhance palliative care and communication learning: A mixed method study. NURSE EDUCATION TODAY 2022; 119:105568. [PMID: 36183609 DOI: 10.1016/j.nedt.2022.105568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/01/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND As palliative care increases in importance due to chronic illnesses in ageing populations, there is a need to develop primary palliative care, including patient-centred communication for nursing graduates. Simulation-based education was adopted to develop students clinical skills and communication in a safer and more controlled environment prior to their clinical practice. However curricula in palliative care and communication remain limited. The current study was to develop a simulation-based programme with clinical modelling prior to the simulation experience. Authentic case scenarios were also constructed through collaboration between the researchers and clinical colleagues in palliative care. OBJECTIVES To explore the effects of palliative care simulation-based experience on nursing students' palliative care and caring communication. DESIGN Mixed-methods with pre- and post-questionnaires and focus groups after the simulation-based experience. SETTINGS A nursing school at a university in Hong Kong. PARTICIPANTS Twenty-nine senior-year undergraduate nursing students. METHODS Students shadowed senior nurses in a palliative clinical setting, then engaged in simulation learning with two palliative scenarios in a laboratory environment. Focus group debriefings were conducted after the simulations. RESULTS Quantitatively, findings from the pre- and post-questionnaires revealed an improvement in the students' knowledge (t = -2.83, p = 0.02), attitudes (t = -4.21, p = 0.00), and efficacy (t = -2.07, p = 0.05) in palliative care after participating in this study. Results from the focus groups also indicated an enhancement in the students' learning of palliative care and communication. CONCLUSION This collaborative design of palliative scenarios and clinical shallowing with senior nurses in a palliative care setting followed by simulation enhanced the students' confidence, knowledge, skills, and attitudes in palliative care and communication.
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Affiliation(s)
| | - Engle Angela Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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Undergraduate Nursing Education and End-of-Life Simulation: A Scoping Review. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bergersen EB, Larsson M, Olsson C. Children and adolescents’ preferences for support when living with a dying parent – An integrative review. Nurs Open 2022; 9:1536-1555. [PMID: 35156340 PMCID: PMC8994933 DOI: 10.1002/nop2.1187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 12/24/2021] [Accepted: 01/30/2022] [Indexed: 11/17/2022] Open
Abstract
Aim To identify and synthesize the evidence base regarding children and adolescents’ preferences for support when living with a dying parent. Design Integrative literature review study. Methods Searches were conducted in PubMed, CINAHL, PsycINFO, the Cochrane Library, Sociological Abstracts and Scopus, between 1 October 2019 and May 2021. Data were analysed and synthesized using integrative thematic analysis according to the analysis stages specified by Whittermore and Knafl. Results Twenty‐two articles were identified. Children and adolescents’ preferences for support were described through one overarching theme, Striving to achieve control and balance, together with six subthemes; “Involvement in the sick parent's care and treatment”; “Wanting to be with the sick parent but needing respite”; “Information must be continuous and individually adapted”; “emotional and communicative support from parents and family members”; “professional, compassionate and informative support”; and “support in friendships and opportunities to maintain normality.”
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Affiliation(s)
- Emily Beatrice Bergersen
- Department of Health Sciences Faculty of Health, Science and Technology Karlstad University Karlstad Sweden
- Section for Advanced Nursing Faculty of Social and Health Sciences Inland Norway University of Applied Sciences Elverum Norway
| | - Maria Larsson
- Department of Health Sciences Faculty of Health, Science and Technology Karlstad University Karlstad Sweden
| | - Cecilia Olsson
- Department of Bachelor Education Lovisenberg Diaconal University College Oslo Norway
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Brohard C, Moreland E, Shammas S, Tonsul R. From Development to Implementation: The Effectiveness of a High-Fidelity Simulation for Advance Care Planning for Undergraduate Nursing Students. J Hosp Palliat Nurs 2021; 23:504-511. [PMID: 34456298 DOI: 10.1097/njh.0000000000000798] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study describes the development and implementation of a high-fidelity simulation as the teaching strategy to enhance undergraduate nursing students' satisfaction, self-confidence, knowledge and learning, collaboration, and communication in providing advance care planning to a terminally ill patient. This original simulation was created using the Healthcare Simulation Standards of Best Practice to incorporate the CARES: Competencies And Recommendations for Educating Undergraduate Nursing Students Preparing Nurses to Care for the Seriously Ill and their Families into the nursing curriculum. A descriptive, quantitative study was conducted for 3 years, evaluating feasibility, sustainability, and student outcomes. Student outcomes were measured with the Frommelt Attitude toward the Care of the Dying Scale, the Student Satisfaction and Self-Confidence in Learning Scale, and Educational Practices Questionnaire. The findings showed the average global scores for the Student Satisfaction and Self-Confidence in Learning Scale (n = 174; mean [SD], 4.28 [0.86]) and for the Educational Practices Questionnaire (n = 164; mean [SD], 4.46 [0.7]), and item scores of each scale were heavily skewed toward the maximum score of 5. The high-fidelity simulation for advance care planning was demonstrated to be feasible and sustainable. As an investment in student learning, it increased the students' active learning, collaboration, communication, satisfaction, and self-confidence while learning how to conduct advance care planning for the terminally ill.
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Condry HM, Kirkpatrick AJ. Simulation in End-of-Life Nursing Education: A Literature Review. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2021.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Orkibi H, Biancalani G, Bucuţã MD, Sassu R, Wieser MA, Franchini L, Raccichini M, Azoulay B, Ciepliñski KM, Leitner A, Varani S, Testoni I. Students' Confidence and Interest in Palliative and Bereavement Care: A European Study. Front Psychol 2021; 12:616526. [PMID: 33679532 PMCID: PMC7930718 DOI: 10.3389/fpsyg.2021.616526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/01/2021] [Indexed: 12/26/2022] Open
Abstract
As part of a European Erasmus Plus project entitled Death Education for Palliative Psychology, this study assessed the ways in which Master's Degree students in psychology and the creative arts therapies self-rated their confidence and interest in death education and palliative and bereavement care. In five countries (Austria, Israel, Italy, Poland, Romania), 344 students completed an online questionnaire, and 37 students were interviewed to better understand their views, interest, and confidence. The results revealed some significant differences between countries, and showed that older respondents with previous experience as formal caregivers for end-of-life clients showed greater interest in obtaining practical clinical competence in these fields. A mediation analysis indicated that students' previous care experiences and past loss experiences were related to students' current interest in death education and palliative and bereavement care through the mediation of their sense of confidence in this field. The qualitative findings identified five shared themes: life and death, learning about death, the psychological burden, personal experience and robust training, and four key training needs. Overall, students' interest in studying and working with terminal illness and death are rooted in internal resources, a preliminary sense of confidence, but also external requirements.
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Affiliation(s)
- Hod Orkibi
- Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Gianmarco Biancalani
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padua, Padua, Italy
| | | | - Raluca Sassu
- Department of Psychology, Lucian Blaga University, Sibiu, Romania
| | | | | | | | - Bracha Azoulay
- Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Krzysztof Mariusz Ciepliñski
- Department of Psychotherapy and Health Psychology, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Alexandra Leitner
- Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | | | - Ines Testoni
- Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel.,Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padua, Padua, Italy
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Gurley L, Roberson J, York AB, Childress J. Interprofessional Team Approach Using Standardized Patient Simulation to Facilitate Person-Centered Quality Healthcare in Home Hospice Care Setting. J Hosp Palliat Nurs 2021; 23:69-77. [PMID: 33252425 DOI: 10.1097/njh.0000000000000724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hospice care requires person-centered holistic approaches from interprofessional health care teams. Traditional curricular models include teaching hospice care in discipline-specific didactic settings. There are limited opportunities for prelicensure students to engage in real-life and hands-on hospice care. Students are often observers and lack meaningful interactions with patients, families, and interprofessional teams. Using "IPEC Core Competencies for Interprofessional Collaborative Practice" and "AACN CARES" as the framework, nursing and social work faculty collaborated to develop, implement, and evaluate an interprofessional home hospice simulation incorporating standardized patients. The purpose of this interprofessional simulation was to facilitate hands-on application of complex health care concepts in an authentic home hospice setting. Twenty-three Bachelor of Science in Nursing students and 10 Master of Social Work students participated as interprofessional teams to provide home hospice care for patients and families. Faculty evaluated the simulation experience through analysis of presimulation and postsimulation guided reflections, intrasimulation observations, and postsimulation debriefing. Evaluation indicated students gained a greater understanding of how to provide quality person-centered end-of-life care, increased comfort with assessing spiritual needs, increased confidence in initiating sensitive interactions, and greater appreciation for working in an interprofessional health care team. This interprofessional simulation provided a robust learning environment paving the way for future simulations incorporating additional members of the health care team.
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Edwards C, Hardin-Pierce M, Anderson D, Rexford T. Evaluation of Self-efficacy and Confidence Levels Among Newly Graduated Nurses Exposed to an End-of-Life Simulation: A Comparison Study. J Hosp Palliat Nurs 2020; 22:504-511. [PMID: 33044419 DOI: 10.1097/njh.0000000000000698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Self-efficacy and confidence levels among newly graduated nurses who participated in an end-of-life simulation were compared with nurses who had been practicing for no more than a year but had not participated in an end-of-life simulation. The study included a pretest-and-posttest evaluation of an end-of-life simulation intervention during a new graduate residency program among newly graduated nurses to improve self-efficacy and confidence with end-of-life care. Nurses who had been in practice for no more than a year but had not been exposed to an end-of-life simulation intervention were also surveyed. The Palliative Care Evaluation Tool Kit was adapted and used for this project. The 2 groups of nurses were compared in terms of self-efficacy and confidence levels regarding end-of-life care. An end-of-life simulation intervention was successful in improving self-efficacy and confidence levels among newly graduated nurses, in regard to views about end of life and death and dying compared with the nurses who did not receive the end-of-life simulation intervention. The results of this study have implications for both schools of nursing and hospital training programs.
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