Online Simulation in Palliative Care Education for Early-Career Nurses in Japan: A Pre-Post Exploratory Evaluation of...

Early-career nurses often encounter difficulties in symptom management and communication with patients and families in palliative care. Although simulation-based education improves clinical competence, most programs require in-person participation. Evidence regarding the feasibility and outcomes of fully online simulation with immediate feedback for palliative care training remains limited.

To examine the perceived outcomes and feasibility of a fully online simulation-based palliative care education program for early-career nurses in Japan.

Exploratory pre-post, single-arm study.

The study was conducted in Japan and included 34 early-career nurses with 2-4 years of clinical experience who participated in a 90-minute online program delivered via Zoom.

The program comprised briefing, simulation, group work, and debriefing sessions focusing on total pain and communication. Outcomes were assessed at baseline, immediately post-intervention, and 1 month after using the Palliative Care Difficulties Scale, Nurses' Difficulty with Cancer Care Scale, Palliative Care Self-reported Practices Scale, and measures of confidence and satisfaction. Open-ended responses were analyzed descriptively.

Scores improved significantly from baseline in Palliative Care Difficulties Scale scores for symptom alleviation (p = 0.024, d = 0.41) and communication (p = 0.002, d = 0.57). Confidence in recognizing total pain (p = 0.008, d = 0.63) and communication (p = 0.011, d = 0.66) increased from baseline. Researcher-rated practice levels improved in 9 of 14 items, and mean satisfaction was 5.2/6. Qualitative findings indicated that most participants applied their learning in clinical practice.

These findings suggest that the program may contribute to improvements in perceived difficulties and confidence, supporting its potential feasibility as an educational model.