Education for pre-licensure programs in end-of-life care at both the baccalaureate and graduate levels, especially interprofessional education (IPE), is a relatively new phenomenon following the development of the Robert Wood Johnson and City of Hope’s End-of-Life Nursing Education Consortium (ELNEC) Core Curriculum (City of Hope & American Association of Colleges of Nursing, 2015). There has been little research from the student’s perspective on the content of end-of-life education curriculum. Although in the early stages of research, IPE using simulation methodology has been shown to be effective in increasing student confidence levels in other areas of patient care (Brown, Howard, & Morse, 2016; Phillips, Hall, & Irving, 2016; Pullon, Wilson, Gallagher, et. al., 2016). Using a quantitative one group pre- and post-test intervention design, the aim of this study was to show the effect of IPE using simulation on perceived confidence levels for end-of-life care in nursing and pharmacy students.
Methods:
This study used a pre- and post-test one group design using the End-of-Life Professional Caregiver Survey (EPCS) (Lazenby, Schulman-Green, & McCorkle, 2012). A convenience sample of undergraduate nursing students and graduate pharmacy students enrolled at a university on the east coast was recruited for the study. Third year nursing and pharmacy students enrolled in either Community Health Nursing or Pharmacy Case Studies courses at the university had participated in two IPE class sessions on other topics before the study class. Preparation and session content included: online preparation using multi-media curriculum materials developed for end-of-life education; an IPE role play simulation; and a faculty led debriefing. The role play simulation case study was developed for the ELNEC core (2015) and is used in both undergraduate, professional, and graduate level programs. Results of the survey were coded and entered into SPSS for analysis using the paired measures t-test for comparison of means within groups.
Results: A sample of 86 pharmacy and nursing students completed both pre-and post-tests surveys. A two-tailed test for dependent groups was used to test for differences in students’ perceptions of personal comfort in caring for dying patients and their families before and after an IPE class offering on end-of-life issues and concepts. The t test revealed that the students’ comfort levels following the class were significantly different from their levels before the class M=(20.40), t=(9.962), df (85), p=.000 with a significant increase in both classes.
Conclusion:
Although the study is limited by a small sample size (n=86) and a one-group design, results may contribute to the practice of undergraduate nursing education and curriculum development using current tools and approaches. Ongoing research is needed with larger samples and an experimental design to reliably inform practice. The World Health Organization estimates that 40 to 60% of all dying patients need palliative care (WHO, 2016). In 2014, a global resolution on palliative care encouraged countries to improve access to palliative care in primary care and home-based services. In the home setting especially, nurses and pharmacists play important roles in safe and effective care. Interdisciplinary collaboration for palliative and end-of-life care promotes optimum outcomes. Provider education for palliative care can utilize an IPE approach with simulated role playing to promote competency in all dimensions of palliative care for patients with life-threatening diseases, especially chronic illness.