Development of a Standardized Simulation: Advance Care Planning Conversations for Nurses

Area of Science:

• Nursing Education
• Healthcare Communication
• Patient Advocacy

Background:

• Advance care planning (ACP) conversations are vital for documenting patient goals but are often incomplete.
• Registered nurses (RNs) require enhanced training in ACP communication skills.
• Hands-on teaching modalities are necessary to improve RNs' confidence and competence in ACP discussions.

Purpose of the Study:

• To develop and test a validated, standardized simulation for RNs to improve knowledge and comfort in ACP communication.
• To examine the feasibility and effectiveness of the 'Conversations Had at Trying Times' simulation.
• To assess changes in RNs' knowledge, attitudes, and self-efficacy regarding ACP.

Main Methods:

• Simulation development guided by construct and content validity, adhering to International Nursing Association for Clinical Simulation and Learning standards.
• Testing involved a pilot one-group pretest/posttest design with 36 RNs.
• The study was framed by the National League of Nursing Jeffries simulation theory and Bandura's self-efficacy theory.

Main Results:

• The 'Conversations Had at Trying Times' simulation successfully enhanced RNs' communication skills.
• Significant increases in knowledge, attitudes, and self-efficacy were observed post-simulation.
• Postsimulation evaluations confirmed the simulation's feasibility, with notable variations among nurses with less than one year of experience.

Conclusions:

• The 'Conversations Had at Trying Times' simulation is feasible and effective for improving RNs' ACP knowledge, attitudes, and self-efficacy.
• Simulation is an underutilized educational tool for enhancing ACP communication skills among nurses.
• Tailored simulation or alternative modalities are recommended for newer nurses, and ACP communication should be integrated into undergraduate nursing education.