Methods: Each of the three universities encountered unique considerations and curricular requirements, resulting in different methods of ELNEC-UG integration. All universities began with formative evaluation of existing palliative care content in their respective programs. The curricular evaluations sought to 1) determine existing palliative and/or end-of-life concepts taught either formally or informally; 2) uncover gaps or repetition; or 3) identify ideal alignment of ELNEC-UG within existing courses. The evaluation process served to uncover gaps and opportunities to standardize and balance the type of palliative care education taught. Additionally, the process served to increase faculty awareness of the importance and relevance of palliative care education. The first university sought to capitalize on the grant-funded option for implementation of the ELNEC-UG modules. One influencing factor in the faculty conversation was recent curricular revision from a competency-focused curriculum toward implementation of a concept-based curriculum. At the second university, the curricular evaluation process resulted in the identification of faculty champions in multiple courses. At the third university, curricular evaluation highlighted gaps in current palliative care education, and student exit surveys emphasized a desire for more education on palliative and end-of-life care. Each university was careful to engage in thoughtful discussions with administration and faculty to determine the ELNEC-UG implementation method that best fit the needs of the respective nursing program.
Results: A common outcome of these exemplars was the belief that threading the modules across multiple courses over several semesters would be the most efficient and developmentally appropriate strategy. Course selection and strategies varied across universities. At the first university, students receive one to two modules per semester over a five-semester, upper-division baccalaureate program. Modules are delivered in courses focusing on communication, community-based care, beginning and advanced acute care, and family nursing. At the second university, faculty championed integration into 4 courses across the Junior year of the program, including one application activities in post-clinical conferences. In addition they have successfully integrated the modules into existing courses in the baccalaureate completion program. At the third university, faculty elected to thread the modules across four courses in two semesters of the Junior year, specifically nursing concepts, pathophysiology, fundamentals of nursing, and pharmacology. Each university reports positive student feedback associated with each implementation method. The first cohorts with access to the modules embedded into courses across the curriculum have resulted in 543 students per year (280 at first university; 153 at second university; 110 at third university) will be graduating with the ELNEC-UG certificate of completion.
Conclusions: The flexibility of the standardized modules allows faculty to incorporate their use into several courses within various curricula. Recommendations include championing the use of the modules through incorporation into course work to ensure maximum visibility and opportunity for completion of the evidence-based palliative care modules.
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