- Title
- The experience of undergraduate nursing students with end of life care and end of life care simulation
- Creator
- Gillan, Pauline
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2019
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- End of life care is a daunting experience for undergraduate nursing students who are largely unprepared to undertake quality care for the dying person and their families. Undergraduate nursing curricula often do not provide adequate education on critical aspects of care at the end of life. End of life care simulation is an emerging, innovative and student centred approach that aims to improve nursing students’ preparedness for end of life care. The aims of this research were to: 1) Explore the end of life experiences, personal and professional, of undergraduate nursing students prior to end of life care simulation; 2) Explore experiences of undergraduate nursing students with end of life care simulation; and 3) Investigate the impact of end of life care experiences and end of life care simulation on the undergraduate nursing student. The research methodology of narrative inquiry was used to address the research aims and unpack the research puzzle of understanding undergraduate nursing students’ experiences with end of life care and end of life care simulation. Data were collected from video recorded end of life care simulation, audio taped simulation debriefing, individual semi-structured interviews, and items of meaning brought to interviews. Eighteen undergraduate nursing students enrolled in one rural university in New South Wales, Australia participated in this study. The three dimensional conceptual framework described by Clandinin and Connelly, underpinned by Dewey’s philosophy of experience, guided this research and was used to analyse participants’ stories. Students’ stories of experience revealed eight significant threads which include: the role of others in shaping death experiences; attending to family at the end of life; theory, practice and experience synergised; managing self, amidst difficult conversations at the end of life; managing self, amidst unfamiliar landscapes of death and dying; defining moments in time; real versus unreal landscapes in simulation; and finding comfort amidst learning and working together. Arising from this research recommendations are made across four landscapes including clinical practice, end of life care education, end of life care simulation, and research on end of life care simulation. Firstly, it is recommended that students are supported during their first death experiences in clinical practice through clinical supervision and reflection and that students be prepared for undertaking post mortem care and the possibility of bad death experiences. It is recommended that end of life care education be commenced early in the undergraduate nursing degree and before the first nursing clinical placement. For end of life care simulation, it is recommended that students be given the opportunity to experience a range of roles involving the family and RN. Furthermore, end of life simulation needs to include all three moments of time across the time continuum (before death, at the time of death, and post mortem) providing a comprehensive and holistic end of life care experience. Additionally, simulation needs to include standardised patients in roles to enhance realism and provide students the opportunity to engage in difficult conversations at the end of life. Finally, it is recommended that simulation include an unfolding scenario approach utilising small group sizes. Recommendations for research include to investigate the best practice for pre-briefing and debriefing of end of life care simulation to ensure psychological safety of students, and research that compares different simulation models of teaching end of life care simulation, for example, comparing unfolding simulation with stand alone cases. Each and every one of us will at some time in our lives be touched by death in its many forms. Nurses, especially student nurses, our registered nurses of the future, need to be emotionally and conceptually prepared to provide sensitive and quality end of life care. Nurse educators and nursing clinicians play a large role in ensuring nursing students are prepared and supported to provide this care during this important time of life. To conclude, through narrative inquiry a deep understanding of undergraduate nursing students’ experiences with end of life care and end of life care simulation has been gained. This understanding informs nursing educators and nursing clinicians who have the power and the ability to transform experiences for nursing students and, therefore, improve the quality of care for patients and their families at the end of life. Additionally, nursing educators, through the use of end of life care simulation, can improve undergraduate nursing students’ preparedness to undertake end of life care in clinical practice. The study reported in this thesis makes an important and original contribution to the scholarly literature on simulation at the end of life and is the first narrative inquiry study that has provided comprehensive insight into undergraduate nursing students’ stories of experience with end of life care and end of life care simulation. This study indicates that end of life care simulation is a strong pedagogical and transformative approach to help prepare undergraduate nursing students to provide quality end of life care in clinical practice.
- Subject
- undergraduate nursing students; end of life care; simulation; narrative inquiry; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1406484
- Identifier
- uon:35634
- Rights
- Copyright 2019 Pauline Gillan
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 16 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 370 KB | Adobe Acrobat PDF | View Details Download |