Evaluating baccalaureate curriculum end-of-life care content based upon End of Life Nursing Education Consortium (ELNEC) guidelines
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Evidence shows that the demand for palliative and end-of-life care is increasing in healthcare, yet nurses lack the proper education to provide this care with confidence and competence. Before educational practices are modified, a method is needed to assess current palliative and end-of-life care education. This dissertation study described a process for assessing a baccalaureate curriculum for its palliative and end-of-life care content integration, using an adapted theoretical framework, the Palliative Care Curriculum Evaluation Model. The End of Life Nursing Education Consortium (ELNEC) Core Curriculum was decomposed to identify all its key elements. Faculty members teaching in a baccalaureate nursing program were surveyed to identify strategies used and courses within which the ELNEC Core Curriculum content was taught. Survey responses from students enrolled in required nursing-specific courses within the curriculum at two time points within the semester were analyzed to assess changes in their knowledge of palliative and end-of-life care, attitudes toward death and toward care of the dying, and perceived competence in providing palliative and end-of-life care. Findings revealed that clinical conference discussion/debriefing and lecture were the most frequently used strategies. The Pain Management and Symptom Management categories were most covered, and Final Hours and Introduction to Palliative Nursing were least covered. There was an overall 95.3% match between the ELNEC Core Curriculum and the baccalaureate curriculum studied when all faculty member survey responses were analyzed, but this incorporated courses with much variability in content covered. There was a 78.45% match when only courses for which the content was covered consistently were analyzed. Baseline student outcomes demonstrated significantly higher results on knowledge and attitudes toward care of the dying measures (p<.02) for students further along in the curriculum as opposed to students toward the beginning of the program. The improvement in perceived competence across the semester for students was not significant, but did have a near-moderate effect size. The findings suggest that the methods used in the study were successful in assessing palliative and end-of-life care education. Implications of the findings for nursing practice, education, policy, and research are discussed.