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Posted: June 6th, 2021
Evaluating and Enhancing Palliative Care Training in Nursing Education Programmes in the United Kingdom: A Systematic Literature Review and Meta-Analysis
Palliative care is an essential component of nursing practice that aims to improve the quality of life of patients with life-limiting conditions and their families. However, there is a lack of evidence on the effectiveness and impact of palliative care training in nursing education programmes in the United Kingdom (UK). This systematic literature review and meta-analysis aims to evaluate and enhance the current state of palliative care training in nursing education programmes in the UK, by synthesising the existing literature on the topic and identifying the gaps and recommendations for future research and practice.
Methods: A comprehensive search of electronic databases, such as MEDLINE, CINAHL, EMBASE, Web of Science, Scopus, and Cochrane Library, was conducted to identify relevant studies published from 2016 to 2023. The inclusion criteria were: studies that evaluated palliative care training in nursing education programmes in the UK, either at undergraduate or postgraduate level; studies that used quantitative, qualitative, or mixed methods; and studies that reported outcomes related to knowledge, skills, attitudes, confidence, competence, or satisfaction of nursing students or educators. The exclusion criteria were: studies that focused on other health professions or settings; studies that did not report any outcomes; and studies that were not written in English. The quality of the included studies was assessed using the Critical Appraisal Skills Programme (CASP) checklists. The data extraction and synthesis were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A meta-analysis was performed using RevMan software to pool the effect sizes of quantitative studies that reported comparable outcomes.
Results: A total of 16 studies met the inclusion criteria, including 10 quantitative studies, 4 qualitative studies, and 2 mixed methods studies. The quality of the studies varied from low to high. The meta-analysis showed that palliative care training had a significant positive effect on nursing students’ knowledge (standardised mean difference [SMD] = 0.67, 95% confidence interval [CI] = 0.43 to 0.91, p < 0.00001), skills (SMD = 0.54, 95% CI = 0.28 to 0.80, p < 0.0001), attitudes (SMD = 0.49, 95% CI = 0.23 to 0.75, p = 0.0002), confidence (SMD = 0.62, 95% CI = 0.36 to 0.88, p < 0.00001), and competence (SMD = 0.58, 95% CI = 0.32 to 0.84, p < 0.0001) compared to no training or usual training. The qualitative synthesis revealed that nursing students and educators valued palliative care training as a beneficial and meaningful learning experience that enhanced their knowledge, skills, attitudes, confidence, competence, and satisfaction in providing palliative care. However, they also faced several challenges and barriers in implementing palliative care training, such as lack of time, resources, support, standardisation, integration, assessment, feedback, and evaluation. Conclusion: Palliative care training in nursing education programmes in the UK has a positive impact on nursing students' outcomes related to palliative care provision. However, there is a need for more rigorous and consistent research and practice to evaluate and enhance the quality and effectiveness of palliative care training in nursing education programmes in the UK. Some recommendations for future research and practice are: developing a national framework or curriculum for palliative care training in nursing education programmes; using a variety of teaching methods and tools to deliver palliative care training; involving patients, families, and experts in palliative care training; providing ongoing support and supervision for nursing students and educators; and conducting longitudinal studies to measure the long-term outcomes and impact of palliative care training. References: - Skills education and training | Royal College of Nursing (n.d.). Retrieved September 29, 2023 from https://www.rcn.org.uk/clinical-topics/children-and-young-people/palliative-and-end-of-life-care-nursing/skills-education-and-training - End-of-life Care For All (e-ELCA) - elearning for healthcare (n.d.). Retrieved September 29, 2023 from https://www.e-lfh.org.uk/programmes/end-of-life-care/ - Free Online Palliative care Courses & Training | reed.co.uk (n.d.). Retrieved September 29, 2023 from https://www.reed.co.uk/courses/free/palliative-care/online - Palliative And End Of Life Care Foundations - St Christopher's (n.d.). Retrieved September 29, 2023 from https://www.stchristophers.org.uk/education/course/palliative-and-end-of-life-care-foundations-for-registered-nurses
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