School of Nursing Poster Presentations

Title

The Impact of an Advance Care Planning Simulation on the Communication Skills of Palliative Care Nurse Practitioner Students

Document Type

Poster

Publication Date

3-2016

Abstract

Background: Effective communication is the cornerstone of a therapeutic relationship, especially when dealing with serious, life threatening illness. Decisions based upon a patient and family’s wishes, goals and values need to be guided by clinicians equipped to engage in complex advance care planning (ACP) conversations. Given its importance, communication skill proficiency has been identified as a core competency for the Advanced Practice Registered Nurse (APRN) in palliative care. Although simulation utilizing a standardized patient model has been employed for communication skills training in healthcare education, little is known about its usefulness in preparing palliative care nurse practitioner students for these challenging ACP discussions.

Objectives: The purpose of this pilot study was to evaluate the impact of advance care planning simulations upon the communication skills and self-efficacy of palliative care nurse practitioner students enrolled in a college of nursing.

Methods: A prospective, quantitative study using a one-group pretest-posttest design was implemented to measure student communication skills and self-confidence. A convenience sample (N=19) of students enrolled in New York University’s College of Nursing was obtained for the study. Students engaged in two ACP discussion simulations with actors playing the role of a newly diagnosed oncology patient. In addition to demographic information, the participants completed a self-confidence tool prior to the first and after the second simulation. An independent faculty member scored the students’ performances for each simulation using a communication skills checklist based on the SPIKES protocol. Statistical analysis of the study variables was performed using paired t test and Wilcoxon signed-rank test measurements. Statistical significance was set at p < .05.

Results: The majority of participants were between the ages of 20-30, had 4-10 years of nursing experience and reported having exposure to patient discussions surrounding healthcare proxy, code status and breaking bad news during their clinical rotations. Fifty-six percent (n =5) of the participants demonstrated improvement in communication skills (t = -.098, p = .924), while ninety-three percent (n = 14) reported increased self-confidence (t = 4.725, p< .001) after completion of the second simulation encounter. Statistical significance for nine of the 14 self-confidence tool items was confirmed by the Wilcoxon signed-rank test. Study limitations included attrition, sample size, intervention timing and scheduling.

Conclusion: Despite mixed results, this pilot provided key insights into the potential for repetitive simulation in communication skills education and the feasibility for future research of this pedagogy in the palliative care nurse practitioner student population.

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Presented at: GW Research Days 2016

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The Impact of an Advance Care Planning Simulation on the Communication Skills of Palliative Care Nurse Practitioner Students

Background: Effective communication is the cornerstone of a therapeutic relationship, especially when dealing with serious, life threatening illness. Decisions based upon a patient and family’s wishes, goals and values need to be guided by clinicians equipped to engage in complex advance care planning (ACP) conversations. Given its importance, communication skill proficiency has been identified as a core competency for the Advanced Practice Registered Nurse (APRN) in palliative care. Although simulation utilizing a standardized patient model has been employed for communication skills training in healthcare education, little is known about its usefulness in preparing palliative care nurse practitioner students for these challenging ACP discussions.

Objectives: The purpose of this pilot study was to evaluate the impact of advance care planning simulations upon the communication skills and self-efficacy of palliative care nurse practitioner students enrolled in a college of nursing.

Methods: A prospective, quantitative study using a one-group pretest-posttest design was implemented to measure student communication skills and self-confidence. A convenience sample (N=19) of students enrolled in New York University’s College of Nursing was obtained for the study. Students engaged in two ACP discussion simulations with actors playing the role of a newly diagnosed oncology patient. In addition to demographic information, the participants completed a self-confidence tool prior to the first and after the second simulation. An independent faculty member scored the students’ performances for each simulation using a communication skills checklist based on the SPIKES protocol. Statistical analysis of the study variables was performed using paired t test and Wilcoxon signed-rank test measurements. Statistical significance was set at p < .05.

Results: The majority of participants were between the ages of 20-30, had 4-10 years of nursing experience and reported having exposure to patient discussions surrounding healthcare proxy, code status and breaking bad news during their clinical rotations. Fifty-six percent (n =5) of the participants demonstrated improvement in communication skills (t = -.098, p = .924), while ninety-three percent (n = 14) reported increased self-confidence (t = 4.725, p< .001) after completion of the second simulation encounter. Statistical significance for nine of the 14 self-confidence tool items was confirmed by the Wilcoxon signed-rank test. Study limitations included attrition, sample size, intervention timing and scheduling.

Conclusion: Despite mixed results, this pilot provided key insights into the potential for repetitive simulation in communication skills education and the feasibility for future research of this pedagogy in the palliative care nurse practitioner student population.