Development of an Enriched Curriculum for Promoting Palliative Care Competencies of Nursing Students

Abstract

This research and development study aimed to do curriculum enrichment for promoting palliative care competencies in nursing students. The development included the 4 following steps. Step 1. Background analysis was performed by: 1) assessing the contents of each nursing subjects included in the current curriculum, 2) reviewing the literature related to palliative care competencies, 3) holding group discussions in 3 nursing colleges (8-10 participants in each group), for data collection of opinions from nurse educators and nursing students on palliative care, as well as 4) conducting a survey on palliative care competencies, knowledge, attitude, and practice among 331 registered nurses in Health Region 11, and 299 nursing students studying at nursing colleges under the Ministry of Public Health. Step 2: Curriculum design was enriched with the following elements: 1) curriculum title, 2) concepts included in the curriculum, 3) objectives, 4)structure, 5) learning activities, based on experiential learning and simulation-based learning, 6) learning outcome evaluation, and 7) learning materials/resources. The curriculum consists of 6 modules: 1) nursing care for palliative care patient, 2) holistic nursing care, 4) pain and symptom management, 5) loss, grief, and bereavement, and 6) preparation for and care at the time of death.  Each module is composed of the following elements: 1) course description, 2) learning objectives, 3) contents, 4) learning methods and activities, 5) learning materials, and 6) learning outcome evaluation. The researchers employed seven experts to validate the curriculum and rate its appropriateness. Step 3: Curriculum implementation was done to test its efficiency, based on 80/80 evaluation criteria. The curriculum was pilot-tested in 30 nursing students during academic year 2017.  Step 4: The researchers adjusted and improved the contents and learning methods and used it for 2^nd time with other 30 nursing students in  academic year 2018. The study revealed the following findings.

1. The enriched curriculum for promoting palliative care competencies of nursing students is appropriate. The experts rated its appropriateness as very high (M=4.51-4.59; SD=0.49-0.59).

2. The criterion for efficiency and achievement of extra curriculum were met (E1/E2 = 86.80/82.73).

3. Compared with the scores before participating in the extra curriculum, nursing students showed a significantly increased score of palliative care knowledge (t=19.15 (29), P<.001) and of attitude (t=3.33 (29), P<.001). One month after the implementation of the program, it was found that most of students (86.66 percent) had palliative practice score at a very good level (M=94.80, SD=14.30).

4. The students’ satisfactorion toward the curriculum was at a high level (M=4.43, SD=0.30).

The curriculum enrichment for promoting palliative care competencies in nursing students is appropriate and can be used or distributed to interested parties or other nursing institutes, in order to be used as a guideline.