Palliative care competence development through simulation: Excellence & innovation to meet the AACN essentials.

BACKGROUND: The updated American Association of Colleges of Nursing: The Essentials: Core Competencies for Professional Nursing Education (2021) outlines competence requirements for entry-to-practice nurses. Hospice and palliative care (PC) are identified as one of four spheres of care, emphasizing that nursing knowledge and proficiency in primary PC are critical for all nurses. PURPOSE: This article identifies key elements for nursing educators to consider when adopting, adapting, or designing practical primary PC simulations to meet The AACN Essentials. METHODS: Using Healthcare Simulation Standards of Best Practice™ (HSSBP) as a framework, a panel of nursing education researchers identified and compared key elements of four PC simulations from varied evidence-based exemplars across the U.S. RESULTS: Overarching elements in simulation development include choosing modalities, assessing resources, and simulation logistics, creating opportunities for difficult conversations with interprofessional team engagement, and validating scenarios with expert input. Simulation implementation should include tailored pre-briefing to address psychological safety in caring for the dying patient, piloting scenarios, and maximizing observer/vicarious learner roles. Finally, evaluation is vital for competency assessment, scenario enhancement, and logistical changes. Limitations included variability in PC simulation scenarios, learners/learner level, curricula, and geography across selected exemplars, which may affect the general applicability of these findings. CONCLUSIONS: Simulations developed according to HSSBP™ provide effective practical experience in PC, affording active and vicarious learners the knowledge and skills essential for baseline nursing competence.

Experiential Learning for Prelicensure Nursing Students: A Pediatric Special Needs Respite Program.

BACKGROUND: A respite program at a southeastern university was developed to provide respite services to local families of children with special needs and to integrate a hands-on clinical experience for nursing students. METHOD: To assess the nursing students' perceptions of participating in the respite program experience, a survey was administered to prelicensure nursing students. RESULTS: Analysis of survey data revealed all participants were satisfied with the respite experience, perceived they will be able to apply knowledge obtained, and acknowledged opportunities to enhance soft skills. Survey results can be used to affirm positive student perceptions associated with a respite clinical learning experience. CONCLUSION: Valuable data describing experiences of undergraduate nursing students who participated in the respite program was obtained. This innovative learning experience meets a community need for children with special needs while providing experiential learning with diverse populations. [J Nurs Educ. 2023;62(3):180-182.].

Vicarious learning and communication self-efficacy: A pediatric end-of-life simulation for pre-licensure nursing students.

BACKGROUND: End-of-life clinical experiences, particularly in pediatrics, are quite limited for pre-licensure nursing students. Though effective, end-of-life simulations can be costly, require facilitators trained in palliative and end-of-life care, and are restricted by limited space and time availability. Such barriers prompt the question as to whether there is an effective alternative to simulation by which students can gain improved self-efficacy in therapeutic communication during pediatric end-of-life situations. PURPOSE: Bandura's Social Cognitive Theory and work exploring self-efficacy posits that vicarious learning provides learners opportunities to gain experience and knowledge through observation of peers in simulated settings. This study evaluated the effectiveness of vicarious versus active learning on pre-licensure nursing students' perceived self-efficacy in providing therapeutic communication during a pediatric end-of-life situation. METHOD: Data were collected over three time points - pre-simulation, post-simulation, and post-debriefing - using a modified Self-Efficacy in Communication Scale. RESULTS: Learners in both groups had significant improvement in self-efficacy across all time points. Only two items had significant differences between vicarious and active learner groups, but the effect was minor. CONCLUSION: Vicarious learning presents as a viable pedagogical approach for providing pre-licensure nursing students important learning opportunities related to pediatric end-of-life simulations during both the scenario and debriefing.