Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-20T01:22:11.008Z Has data issue: false hasContentIssue false
  • English
  • Français

Enhancing student communication during end-of-life care: A pilot study

Published online by Cambridge University Press:  17 April 2015

Jacqueline G. Bloomfield ,
Bernadette O'Neill  and
Karen Gillett
Jacqueline G. Bloomfield*
Affiliation:
Sydney Nursing School, The University of Sydney, Sydney, Australia
Bernadette O'Neill
Affiliation:
King's College London School of Medicine, London, England
Karen Gillett
Affiliation:
Florence Nightingale School of Nursing and Midwifery, King's College London, London, England
*
Address correspondence and reprint requests to: Jacqueline G. Bloomfield, Director of Preregistration Programs, Sydney Nursing School, The University of Sydney, 88 Mallett Street, Sydney, New South Wales 2011, Australia. E-Mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Quality end-of-life care requires effective communication skills, yet medical and nursing students report limited opportunities to develop these skills, and that they lack confidence and the related competence.

Objectives:

Our purpose was to design, implement, and evaluate an educational intervention employing simulated patient actors to enhance students' abilities to communicate with dying patients and their families.

Methods:

A study employing a mixed-methods design was conducted with prequalification nursing and medical students recruited from a London university. The first phase involved focus groups with students, which informed the development of an educational intervention involving simulated patient actors. Questionnaires measuring students' perceptions of confidence and competence levels when communicating with dying patients and their families were administered before and after the intervention.

Results:

The themes from focus groups related to responding to grief and anger, difficulties dealing with emotions, knowing the “right thing” to say, and a lack of experience. A significant increase (p < 0.5) in competence and confidence from baseline levels followed participation in the simulated scenarios.

Significance of Results:

Simulation was found to be an effective means of preparing students to communicate with dying patients and their families. The opportunity to develop communication skills was valued. Integration of educational interventions employing simulated patient actors into nursing and medical curricula may assist in improving the care provided to patients at the end of life.

Keywords

SimulationEnd-of-life careCommunication skillsSimulated patientsMedical studentsNursing students
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 6 , December 2015 , pp. 1651 - 1661
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Ahrens, T., Yancey, V. & Kollef, M. (2003). Improving family communication at the end of life: Implications for length of stay in the intensive care unit and resource use. American Journal of Critical Care, 12, 317–324.CrossRefGoogle ScholarPubMed
Allchin, L. (2006). Caring for the dying: Nursing students' perspectives. Journal of Hospice & Palliative Nursing, 8(2), 112–117.CrossRefGoogle Scholar
Aspegren, K. (1999). BEME Guide No. 2: Teaching and learning communication skills in medicine—a review with quality grading of articles. Medical Teacher, 21, 6.CrossRefGoogle ScholarPubMed
Barbour, R. (2005). Making sense of focus groups. Medical Education, 39(7), 742–750.CrossRefGoogle ScholarPubMed
Berragan, L. (2011). Simulation: An effective pedagogical approach for nursing. Nurse Education Today, 31, 660–663.CrossRefGoogle ScholarPubMed
Billings, M., Engelberg, R., Curtis, R., et al. (2010). Determinants of medical students' perceived preparation to perform end-of-life care, quality of end-of-life care education, and attitudes toward end-of-life care. Journal of Palliative Medicine, 13(3), 319–326.CrossRefGoogle ScholarPubMed
Bradley, P. (2006). The history of simulation in medical education and possible future directions. Medical Education, 40(3), 254–262.CrossRefGoogle ScholarPubMed
Bremner, M., Aduddell, K. & Amason, J. (2008). Evidence-based practices Related to the human patient simulator and first-year baccalaureate nursing students' anxiety. Online Journal of Nursing Informatics, 12(1). Available from http://ojni.org/12_1/bremner.html. Last accessed January 19, 2015.Google Scholar
Cooper, J. & Barnett, M. (2005). Aspects of caring for dying patients that cause anxiety in first-year student nurses. International Journal of Palliative Nursing, 11(8), 423–430.CrossRefGoogle ScholarPubMed
Costello, J. (2011). Talking about death, dying and the end of life. International Journal of Palliative Nursing, 17(4), 159.CrossRefGoogle ScholarPubMed
Department of Health (2008). End-of-life care strategy: Promoting high-quality care for adults at end of life. Available from http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_086277. Last accessed March 16, 2011.Google Scholar
Efstathiou, N. & Walker, W. (2014). Interprofessional, simulation-based training in end-of-life care communication: A pilot study. Journal of Interprofessional Care, 28(1), 68–70.CrossRefGoogle ScholarPubMed
Francis, R. (2013). The Mid Staffordshire NHS Foundation Trust, public inquiry. Available from http://www.midstaffspublicinquiry.com/report. Last accessed June 15, 2013.Google Scholar
General Medical Council (2009). Tomorrow's doctors: Outcomes and standards for undergraduate medical education. Available from http://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009_foreword.asp. Last accessed May 15, 2013.Google Scholar
Gibbins, J., McCoubrie, R. & Forbes, K. (2011). Why are newly qualified doctors unprepared to care for patients at the end of life? Medical Education, 45, 389–399.CrossRefGoogle ScholarPubMed
Gillan, P., van der Riet, P. & Jeong, S. (2014). End-of-life care education, past and present: A review of the literature. Nurse Education Today, 34(3), 331–342.CrossRefGoogle ScholarPubMed
Hamilton, C.A. (2010). The simulation imperative of end-of-life education. Clinical Simulation in Nursing, 6(4), e131–e138.CrossRefGoogle Scholar
Kehl, K. (2006). Moving towards peace: An analysis of the concept of a good death. The American Journal of Hospice & Palliative Medicine, 23(4), 277–286.CrossRefGoogle Scholar
Koponen, J., Pyörälä, E. & Isotalus, P. (2012). Comparing three experiential learning methods and their effect on medical students' attitudes to learning communication skills. Medical Teacher, 34(3), e198–e207.CrossRefGoogle ScholarPubMed
Lane, C. & Rollnick, S. (2005). The use of simulated patients and role-play in communication skills training: A review of the literature to August 2005. Patient Education and Counseling, 67, 13–20.CrossRefGoogle Scholar
Lapkin, S., Levett-Jones, T. & Gilligan, C. (2013). A systematic review of the effectiveness of interprofessional education in health professional programs. Nurse Education Today, 33, 90–102.CrossRefGoogle ScholarPubMed
Lauder, W., Roxburgh, M., Holland, K., et al. (2008). Nursing and midwifery in Scotland: Being fit for practice. The report of the Evaluation of Fitness for Practice Pre-Registration Nursing and Midwifery Curricula Project. Dundee: NHS Education for Scotland, University of Dundee. Available from: http://www.nes.scot.nhs.uk/practice_education/work/evaluation/documents/FFPFINALREPORTsept082.pdf. Last accessed May 13, 2013.Google Scholar
Lefroy, J., Brosnan, C. & Creavin, S. (2011). Some like it hot: Medical student views on choosing the emotional level of a simulation. Medical Education, 45(7), 354–361.CrossRefGoogle ScholarPubMed
Maran, N. & Glavin, R. (2003). Low- to high-fidelity simulation: A continuum of medical education? Medical Education, 37(Suppl. 1), 22–28.CrossRefGoogle ScholarPubMed
Meakim, C., Boese, T., Decker, S., et al. (2013). Standards of best practice. Simulation: standard I: Terminology. Clinical Simulation in Nursing, 9, S3–S11.CrossRefGoogle Scholar
Meyers, S. & Raspa, R. (2007). Crossing disciplinary boundaries in end-of-life education. Journal of Professional Nursing, 23(4), 201–207.Google Scholar
NHS (2011). National end-of-life care program. Available from www.endoflifecare.nhs.uk/. Last accessed June 15, 2013.Google Scholar
NICE (2011). QS13 quality standard for end-of-life care for adults. Available from http://publications.nice.org.uk/quality-standard-for-end-of-life-care-for-adults-qs13. Last accessed June 15, 2013.Google Scholar
Nursing and Midwifery Council (2010). Standards for pre-registration nursing education. Available from http://standards.nmc-uk.org/Pages/Welcome.aspx. Last accessed May 1, 2013.Google Scholar
Page-Cutrara, K. (2014). Use of prebriefing in nursing simulation: A literature review. The Journal of Nursing Education, 53(3), 136–141.CrossRefGoogle ScholarPubMed
Parry, M. (2011). Student nurses' experiences of their first death in clinical practice. International Journal of Palliative Nursing, 17(9), 448–453.CrossRefGoogle ScholarPubMed
Peterson, J., Johnson, M., Halvorsen, B., et al. (2010). What is so stressful about caring for a dying patient? A qualitative study of nurses' experiences. International Journal of Palliative Nursing, 16(4), 181–167.CrossRefGoogle Scholar
Pike, T. & O'Donnell, V. (2010). The impact of clinical simulation on learner self-efficacy in pre-registration nursing education. Nurse Education Today, 30(5), 404–410.CrossRefGoogle ScholarPubMed
Sanford, P.G. (2010). Simulation in nursing education: A review of the research. The Qualitative Report, 15(4), 1006–1011.Google Scholar
Schim, S.M. & Raspa, R. (2007). Crossing disciplinary boundaries in end-of-life education. Journal of Professional Nursing, 23(4), 201–207.CrossRefGoogle ScholarPubMed
Webb, C. & Kevern, J. (2000). Focus groups as a research method: A critique of some aspects of their use in nursing research. Journal of Advanced Nursing, 33(6), 798–805.CrossRefGoogle Scholar