Barriers and Facilitators to ELNEC Undergraduate Integration Into Nursing Curricula

Purpose: Nurses are in a unique position to promote well-being and alleviate suffering. National nursing organizations have endorsed the recommendation that nurses across care settings provide primary palliative care (PPC) to seriously ill patients. Consequently, pre-licensure nursing programs must provide education in PPC principles to better prepare students entering practice. In response to these calls for PPC education, some nursing programs have readily adopted the End of Life Nursing Education Consortium Undergraduate (ELNEC-UG) online curriculum as the formal means of PPC education. Despite a general agreement that nursing students need PPC skills, the complexities of making such a change has not been without its challenges. The purpose of this presentation is to explore barriers to ELNEC-UG adoption and present a toolkit of successful approaches and facilitators that can be used by educators across the United States.

Methods: Since 2017, a team of researchers and educators from across the United States have collaborated on ELNEC-UG implementation research. Many team members experienced barriers to ELNEC-UG adoption in their programs. Similarly, team members have provided consultation and support to educators across the country who have struggled to facilitate ELNEC-UG adoption within their programs. The research team monitored consistently reported barriers as well as successful solutions that worked.

Results: Team members and educators across the country have consistently reported four categories of barriers that preclude ELNEC-UG adoptions: 1) administrative challenges; 2) curricular structure; 3) student challenges; and 4) faculty challenges. Some challenges are experienced in isolation; whereas other faculty members report experiencing multiple challenges. Facilitators that have successfully resulted in ELNEC-UG adoption focus on administrative processes, careful consideration of costs, presentation of benefits to students, and providing faculty support. Collecting faculty and student satisfaction data helped identify strengths and obstacles and provided useful feedback to faculty as a means to sustain the change and make needed modifications. Educators may have to use different strategies dependent upon their respective barriers.

Conclusion: Integrating change into any nursing curriculum is complex, challenging, and can be met with much resistance. The proposed strategies can help faculty efficiently and swiftly address an important gap in nursing education with minimal curricular reorganization. The ELNEC-UG implementation team can provide further support when more strategies are needed.