Evaluating simulation as a teaching and learning strategy to develop student skills and confidence in End of Life Care

Abstract Providing care to a person and their family near the end of life, is a challenging and memorable aspect of nursing practice (Anderson et al 2015). Patient deaths can be a source of distress and discomfort for a nurse; more so for a student, where a lack of discourse regarding end of life care in nursing education has been noted (Ferguson & Cosby 2017). Simulation has been suggested as an innovative strategy to help prepare undergraduate nursing students for end of life care (Gillan et al 2014, Ferguson & Cosby 2017). In response, a simulation workshop was developed and integrated into the final year of an undergraduate, pre-registration adult nursing programme. The case scenario, delivered using a high fidelity mannequin, and involving the multidisciplinary team and a relative, was designed to enable students to explore communication and decision making within a framework of person-centredness. Students worked through the scenario in ‘real – time’ over the course of a shift, and practised handover skills between groups and worked through a framework of prompts to structure peer feedback and debriefing. All students participated in the simulation activity. Ahead of the simulation, following permissions to access the cohort and ethical approval being granted, consent from students was sought to conduct an evaluation of the learning experience. Using a validated simulation survey tool, a questionnaire was administered pre-simulation to determine student attitudes to providing end of life care, and past experiences and skills in this area. Post simulation, a further questionnaire examining student development in these areas as well as their experience of the learning activity itself, was administered. The data were analysed with reference to Kirkpatrick’s 4 level model for evaluation of training interventions. This paper will present an outline of the simulation, the findings of the student evaluation, and a reflection of the facilitator experiences. The paper provides an insight into how an End of Life simulation can be incorporated into a pre-registration programme.

https://www.rcn.org.uk/