The development and pilot testing of an ACP simulation-based communication-training program: Feasibility and acceptability

Abstract

The lack of knowledge of advance care planning and training of communication skills among nurses in Taiwan is one of the main reasons for the low rate of advance directive signing. However, there is no specific and effective solution to this problem. The purposes of this study were (1) to develop and pilot testing of an advance care planning simulation-based communication training program and (2) to evaluate the feasibility and acceptability of the program. This study was conducted in three phases. Phase 1: Developing an advance care planning simulation-based communication training program; Phase 2: Conducting a pilot test; Phase 3: Evaluating the feasibility and acceptability of the program. Twelve convenient participants from a medical center in central Taiwan were selected. The participants believed that team-based learning was beneficial for several reasons. First, it helped to clarify the participants’ understanding of advance care planning and improve their communication skills. Second, role-playing, as one of the components, was helpful for discovering their own shortcomings in communication skills while debriefing enabled them to identify their blind spots in the communication process. Finally, the reflection log documented their weekly performance so they were able to reflect upon their weekly performance, improve their performance, and become more confident. All twelve participants signed the consent form and completed the whole training program. The participants were satisfied with the program, affirming that the timing and content of the program were appropriate and that the expected learning outcomes could be achieved. According to participant feedback, the program was beneficial in improving their knowledge of advance care planning and confidence in communication. Thus, it is feasible and acceptable to introduce communication of advance care planning programs into the staff training protocols of healthcare organizations. Clinical trial registration: NCT04312295.

Simulation-based learning in palliative care in postgraduate nursing education: a scoping review

“…Papers included nurses with varying backgrounds who participated in different education programmes. The participants were advanced practice registered nurse students [ 37 ]; family nurse practitioner students [ 38 ]; advanced practice registered nurses [ 39 ]; graduate nursing students in critical care [ 40 ]; postgraduate students in intensive care [ 41 ]; acute nurse practitioner students [ 42 ]; and nurses employed in palliative care units / inpatient hospice, palliative care consultation teams, general medical wards or medical centres [ 43 – 45 ]. In one paper, participants’ workplaces and specialties were not reported [ 46 ].…”

“…Two papers used a mixed-methods design [ 39 , 40 ], three used a pre- and post-test design [ 38 , 42 , 44 ], one used a randomized controlled trial design [ 43 ], one was a pilot feasibility study [ 45 ], one used a qualitative phenomenographic approach [ 41 ], one used a longitudinal survey design [ 46 ] and one used an evaluation study design [ 37 ].…”

“…In three papers the main focus was on communication [ 42 , 44 , 45 ], while two papers focused primarily on communication about advance care planning [ 38 , 46 ]. Six papers used role playing as the SBL activity [ 38 , 39 , 43 – 46 ], while six described simulation training with the use of scenarios [ 37 , 38 , 40 – 42 , 45 ]. One study used an online case module first, later combined with a workshop [ 37 ].…”

“…All the studies described a variety of active participation from the students. The papers described and used different models and tools, including the COMFORT communication model (a holistic, patient-centred communication model consisting of seven tenets [ 42 , 44 ]), the EXCELL programme (an educational innovation to develop nurses’ intercultural communication skills [ 40 ]), the E-FIELD programme (an EOL communication skills training programme [ 46 ]), the PREPARED model (a communication guide with eight steps [ 45 ]) and the Spiritual Pain Assessment Sheet (a structured assessment sheet to document spiritual pain [ 43 ]). The characteristics of the studies included in the review are described in Table 2 .…”

“…The participants reported that SBL had improved their ability to communicate during difficult conversations [ 42 , 44 , 45 ]. Participants felt a significant increase in satisfaction and competence in their management of emotional needs at the EOL [ 44 ].…”