A new pedagogical approach to enhance palliative care and communication learning: A mixed method study

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.