The Use of Simulation to Teach Nursing Students and Clinicians Palliative Care and End-of-Life Communication: A Systematic Review

Abstract

Objectives:To present the findings of a systematic review on the use of simulation-based learning experiences (SBLEs) to teach communication skills to nursing students and clinicians who provide palliative and end-of-life care to patients and their families.Background:Palliative care communication skills are fundamental to providing holistic patient care. Since nurses have the greatest amount of direct exposure to patients, building such communication competencies is essential. However, exposure to patients and families receiving palliative and end-of-life care is often limited, resulting in few opportunities to learn these skills in the clinical setting. Simulation-based learning experiences can be used to supplement didactic teaching and clinical experiences to build the requisite communication skills.Methods:Searches of CINAHL, MEDLINE, PsychINFO, ERIC, and Web of Science electronic databases and Grey Literature returned 442 unique records. Thirty articles met the established criteria, including the SBLE must contain a nursing role.Results:Simulation-based learning experience are being used to teach palliative and end-of-life communication skills to nursing students and clinicians. Lack of standardization, poor evaluation methods, and limited exposure to the entire interprofessional team makes it difficult to identify and disseminate validated best practices.Conclusion:While the need for further research is acknowledged, we recommend this evidence be augmented by training programs that utilize SBLEs through (1) applying standards, (2) clearly specifying goals and objectives, (3) integrating externally validated scenarios, and (4) employing rigorous evaluation methods and measures that link the SBLE to the training objectives and desired clinician practice behaviors and patient outcomes.

Nursing students' perception on transferring experiences in palliative care simulation to practice

“…Although students benefit from different teaching strategies (Alt-Gehrman, 2017;Venkatasalu, Kelleher, & Chun Hua, 2015), in this field, reflection on competence and their own reactions to death is warranted Henoch et al, 2017). Reflection is emphasised as a cornerstone for learning in simulation-based education (Decker et al, 2013;Fanning & Gaba, 2007;Husebø, O'Regan, & Nestel, 2015), and simulation is recommended as an active learning approach to prepare students for palliative care (Kirkpatrick, Cantrell, & Smeltzer, 2017;Smith et al, 2018;Venkatasalu et al, 2015). Jeffries (2005, p. 97) defines simulation as "activities that mimic a clinical environment where you can train procedures, decision-making and conduct critical thinking using role play, games, video or simulators."…”

“…Identifying gaps in the literature and providing directions for future research is how students transfer learning outcomes from simulation into clinical practice (Kirkpatrick et al, 2017;Smith et al, 2018;Stroup, 2014;Venkatasalu et al, 2015).…”

The Second Conversation project: ­Improving training in end of life care communication among junior doctors

“…Feedback also suggests that the Second Conversation offered additional training elements that role-play and simulation methods do not provide, for example, junior doctors referred to it 'breaking the barrier' of talking about end of life and feeling comfortable to use the word 'death' in a real-life conversation. Although simulation and role play have been advocated as a means of offering a safe, 'low-risk' learning environment, 10,11 junior doctors who took part in a second conversation did not report feeling out of their depth; as it would appear that being part of the initial conversation offered time to prepare and also helped develop a sense of familiarity with the situation. However, the results of a recent systematic review assessing the effectiveness of EoLC communication skills showed that the impact on trainee behaviours was greater in simulated interactions rather than 'real-life' interactions.…”

Fostering gerontology students’ competence in Interprofessional collaborative practice

“…Some respondents proposed simulation-based teaching when delivering interprofessional education. It has been suggested that simulation helps expose students to clinical situations that are unlikely to be experienced in the classroom [ 19 ]. The use of scenarios adapted from real case conferences encourages learning through informal discussion among students about the simulated clients’ conditions and functions of other health professionals, and stimulates their critical thinking capacity [ 20 ].…”