Palliative care competence development through simulation: Excellence & innovation to meet the AACN essentials

Background: The updated American Association of Colleges of Nursing: The Essentials: Core Competencies for Professional Nursing Education (2021) outlines competence requirements for entry-to-practice nurses. Hospice and palliative care (PC) are identified as one of four spheres of care, emphasizing that nursing knowledge and proficiency in primary PC are critical for all nurses.

Purpose: This article identifies key elements for nursing educators to consider when adopting, adapting, or designing practical primary PC simulations to meet The AACN Essentials.

Methods: Using Healthcare Simulation Standards of Best Practice™ (HSSBP) as a framework, a panel of nursing education researchers identified and compared key elements of four PC simulations from varied evidence-based exemplars across the U.S.

Results: Overarching elements in simulation development include choosing modalities, assessing resources, and simulation logistics, creating opportunities for difficult conversations with interprofessional team engagement, and validating scenarios with expert input. Simulation implementation should include tailored pre-briefing to address psychological safety in caring for the dying patient, piloting scenarios, and maximizing observer/vicarious learner roles. Finally, evaluation is vital for competency assessment, scenario enhancement, and logistical changes. Limitations included variability in PC simulation scenarios, learners/learner level, curricula, and geography across selected exemplars, which may affect the general applicability of these findings.

Conclusions: Simulations developed according to HSSBP™ provide effective practical experience in PC, affording active and vicarious learners the knowledge and skills essential for baseline nursing competence.