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"A Role You can Fill": Education Legitimizes Allied Health and Nursing Roles in Advance Care Planning: A Mixed
Wendy Kinton1, Laine Chilman, Catherine Joyce
1Dr. Kinton: End of Life Care Program Coordinator, Community and Preventive Health, Sunshine Coast Hospital and Health Service (End of Life Care), Birtinya, Qld, Australia, and Adjunct Senior Lecturer, University of the Sunshine Coast, (School of Health), Sippy Downs, Qld, 4575 Australia. Dr. Chilman: Senior Lecturer in Occupational Therapy, School of Health, University of the Sunshine Coast, Sippy Downs, Qld, Australia, and Indigenous and Transcultural Research Centre, University of the Sunshine Coast, Sippy Downs, Qld, Australia. Dr. Joyce: National Manager, Advance Care Planning Australia, Metro South Health, Brisbane South Palliative Care Collaborative, Eight Mile Plains, Qld, Australia, and Adjunct Associate Professor, School of Public Health, University of Queensland. Dr. Parker: Director, Brisbane South Palliative Care Collaborative, caring@home & Quality Use of Community Palliative Medicines, Advance Care Planning Australia, Statewide Palliative Care Digital Health Support Unit & Metro South Health Advance Care Planning Service, Co-Director, Statewide Office of Advance Care Planning & PallConsult, Deputy Director, Metro South Palliative Care Service, Chair, Statewide Specialist Palliative Care Services Digital Working Group, and Senior Lecturer, Griffith University, University of Queensland. Dr. Oprescu: Associate Professor, School of Health, University of the Sunshine Coast, Sippy Downs, Qld, Australia. Dr. Burritt: Lecturer in Occupational Therapy, School of Health, University of the Sunshine Coast, Sippy Downs, Qld, Australia, Assistant Professor in Occupational Therapy, Bond University, Robina, Qld, Australia, and Research Collaboration for Women's and Children's Health and Sport, Bond University, Robina, Qld, Australia.
Introduction:
The implementation of advance care planning (ACP) has traditionally been confined to medical officers and specialist nurses. This study evaluated the effect of a multimodal Advance Care Planning Education (ACPEd) program for allied health professionals and generalist nurses.
Methods:
Conducted within a regional health service in Queensland, Australia, the study used a single-arm, explanatory sequential mixed methods design involving 30 participants completing a three-hour workshop, and a learning circle attended by 10 participants. Quantitative data were collected through preintervention and postintervention surveys assessing perceived confidence, knowledge, skills, and role legitimacy. Qualitative data from the learning circles explored changes in clinical practice and role identity.
Results:
Significant improvements were observed in confidence, t (29) = -7.820, P= <.001; knowledge, t (27) = -12.87, P= <.001; and skills, t (29) = -6.814, P= <.001. There was no significant change in perceived health professional roles, t (26) = 2.182, P= .19, indicating a strong belief that all health professional groups have a role in ACP. Three overarching themes emerged: prioritizing ACP, recognizing role legitimacy, and evolving perspectives on engagement. Despite persistent barriers including time constraints and team dynamics, participants demonstrated increased capacity and intent to initiate ACP discussions, with the ACP Tracker a key facilitator for clinical care.
Discussion:
The findings suggest that targeted, interprofessional education may support the development of role identity and legitimacy for ACP among allied health professionals and generalist nurses. The ACPEd program is a scalable model for embedding ACP into practice, with implications for policy and professional development.
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