What is known about simulating advance care planning discussions for healthcare professionals and its impact on patients and learners?
Introduction: Good communication with patients and families as part of Advance Care Planning (ACP) and End of Life (EOL) care is key to ensuring our patients receive person-centred and respectful care. Simulation-based education can be used to train healthcare professionals in communication skills u...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
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| Series: | Future Healthcare Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2514664525002255 |
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| Summary: | Introduction: Good communication with patients and families as part of Advance Care Planning (ACP) and End of Life (EOL) care is key to ensuring our patients receive person-centred and respectful care. Simulation-based education can be used to train healthcare professionals in communication skills used in ACP and EOL care discussions. Simulation-based education provides learners with the opportunity to experience how these discussions may feel as both a healthcare professional and a patient, as well as learn from colleagues and their experiences. Such education can also highlight the challenges that may arise during such discussions and what other factors may need to be considered to ensure a compassionate and holistic experience for patients.The aim of this study was to examine what is known about simulating ACP discussions for healthcare professionals and its impact on patients and learners. Materials and methods: We applied Arksey and O’Malley’s framework to identify relevant studies that met the inclusion criteria for our scoping review question. Three databases (MEDLINE, Embase and Web of Science) were searched with the keywords ‘simulation-based education’, ‘advance care planning’ and ‘Do Not Attempt Cardiopulmonary Resuscitation (DNACPR)’. This resulted in 84 citations. After screening these studies and applying our exclusion criteria, there were 18 studies selected for inclusion. Results and discussion: Of the 18 included studies, 10 (56%) originated from the USA, with 12 (67%) being published within the 6 years previous to this scoping review. Twelve (67%) studies used a qualitative approach to their research. Five (28%) studies included more than two healthcare disciplines in their research. Seventeen (94%) studies used healthcare professionals from various stages of training. All studies used face-to-face simulation with a simulated or standardised patient. Seventeen (94%) studies found improvements in confidence and communication skills with regards to ACP and EOL. Two (11%) studies found improvements in attitudes toward ACP and EOL care, with one (6%) study finding no improvement in patient-reported communication skills in ACP or EOL discussions. Two (11%) studies reported efforts to ensure psychological safety for learners, screening for emotional distress and offering psychological support. Conclusion: The use of simulation-based education as an educational modality for ACP training has been proven to be effective in improving confidence and communication skills amongst healthcare professionals. However, there is scope to develop it further to include a greater breadth of interdisciplinary learning, to examine the effect of cultural context and spiritual care on learning, and to determine the lasting effects this learning has on learners and on the care of their patients. It is also effective when used alongside other teaching techniques as part of a wider educational programme. |
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| ISSN: | 2514-6645 |