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Factors Associated with Integrating Clinical End-of-Life Care Simulations and Hospice Experiences in Pre-licensure Nursing Curricula

Abstract

This exploratory qualitative research study investigated factors associated with curriculum design and implementation of clinical end of life care (EOLC) experiences for prelicensure nursing students via real life practicums or simulations. Six participants who were professors or directors from nursing schools in California and reported experience designing and implementing EOLC curriculum were individually interviewed by phone for approximately one hour to discuss barriers, facilitators, trends, and other factors related to EOLC education at their schools. Participants reported changes within their curriculum relating to EOLC and the teaching methods they use, with one school recently including a clinical hospice rotation, two schools planning to expand clinical experiences, and a third participant expressing a desire to expand both live and simulated EOLC experiences. Greater inclusion of EOLC clinical practice experiences tended to correlate to both leadership and co-faculty support and professional experience with EOLC. Time constraints, crowded curriculums, availability of clinical placements, cost of mannequins, and perceived student readiness were limiting factors. Evaluation of clinical experiences were largely communication based and done through debriefing and written reflections. COVID-19 was found to be a limiting factor in access to clinical sites and sometimes sim labs during surges. Given that this was preliminary exploratory research, more research is needed on larger scales to determine factors influencing EOLC curriculum design and best practices.

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