Baccalaureate Nursing Education and Palliative Care

Saturday, 28 October 2017

Kathryn L. Ferner, BSN
Kenneth R. White, PhD, APRN
School of Nursing, University of Virginia, Charlottesville, VA, USA

Purpose: Palliative and end-of-life (EOL) care has risen as a priority in nursing education programs. The purpose of this study is to evaluate the perceived competency, knowledge, preparation, and learning needs for providing (EOL) and palliative care of baccalaureate nursing students. The research question is: In one institution are nursing students adequately prepared for palliative and EOL care?

Methods: The study design included dissemination of a palliative care competency survey through a web-enabled application to undergraduate third and fourth year nursing students (n=94; response rate: 53.4%) at the University of Virginia School of Nursing. The survey included questions that asked the participants to rank the palliative care core competencies on importance. The participants were also asked to rank their perceived competence in the same palliative care core competencies. Additional questions included the types of education students received on EOL and palliative care, rank ordering the types of education by effectiveness, experience with EOL care, and comfort level providing EOL care.

Results: Participants indicated that end-of-life and palliative care core competencies overall were important for patient care, with an emphasis on communication and pain management. Overall students reported higher levels of competence with pain (74%) and symptom management (71%) and self-care (72%), than with communication aspects of care. Fifty-seven percent of participants reported satisfaction with their learning. Students reported the largest gap between what they ranked as most important and how they ranked their perceived preparation in palliative care education to be communication with patients and families regarding death and dying. Simulation and interactive discussion were reported as the most desirable methods of education. Only 22% of the participants reported feeling comfortable while providing end-of-life and palliative care as students. Sixty-seven percent reported lacking competence in communicating with patients at the end of life as the top competency gap.

Discussion: Students indicated that the palliative care core competencies are important in the care of patients; however, less than a fourth felt comfortable providing palliative care. Students reported higher levels of competency in physical aspects of palliative care such as pain and symptom management than with emotional aspects of care, such as communication with patients and families about death and dying. This may reflect the concept that students are better able learn physical aspects of care through lecture than emotional aspects of care. Students also reported a desire for further interactive methods of learning such as interactive discussion and simulations. The high level of reported competency with self-care may reflect the unique curriculum at the University of Virginia, which has an emphasis on self-care, resilience, mindfulness, and other aspects of nursing care that contribute to burnout. Results of this single institution study provide insight into students’ perceptions of their educational competencies on end-of-life and palliative care. Overall students did not feel competent or confident providing palliative and EOL care. These findings suggest ways for improving the educational methods and topics in undergraduate nursing curricula regarding palliative care.