Palliative care communication simulation to enhance undergraduate skills.

Nurses play a pivotal role in providing end-of-life care (EoLC) for both patients and their families, irrespective of site of care. Many value the time they spend with patients, whilst others experience anxiety and distress due to lack of confidence, knowledge or preparedness. Educational opportunities that simulate EoLC prepare undergraduate nursing and midwifery students for the realities of their future practice.

This research aimed to explore the impact of using a simulated patient in a palliative care communication simulation, on the attitudes toward and comfort with EoLC for undergraduate nursing and midwifery students. The demographic profile of the participants, and their previous personal or professional experience with death was also explored.

A quantitative approach was used to explore the impact of a palliative care communication simulation on second year nursing or third year nursing and midwifery students at a major Australian university in 2021. Data collected participants' demographics and used the Frommelt Attitudes Towards Care Of the Dying (FATCOD), to assess the attitudes of the participants both pre and post the simulation.

A paired t-test was performed to evaluate the impact of the educational intervention on participants FATCOD scores, pre and post the simulation. There was a statistically significant increase in FATCOD score from pre simulation (M =115.64, SD =12.80) to post simulation (M = 121.45, SD = 13.44), t(89) = 6.62, p <.001 (two-sided).  The mean increase in FATCOD scores was 5.81 with a 95% confidence interval ranging from 4.06 - 7.55.  Cohen’s d = .69 implying a moderately large effect size. A statistically significant increase in more positive attitudes was observed.

Differences in the number of pre-simulation survey responses versus complete post-simulation surveys received restricted the responses that could be included in the analysis. Additionally participants had two valuable, but different active experiences during the simulation.

This research has demonstrated an improved attitude towards the care of the dying, so similar interventions within the undergraduate course may help prepare graduate nurses to the new challenges of caring in a palliative care context.

As the goal of nursing care education is to prepare students for future practice, it is anticipated this research will further enhance preparation of undergraduate nursing students in palliative and EoLC contexts.