Death education : simulating the end of life to beginning healthcare providers

Abstract

The national Quality End-of-Life Care Coalition of Canada report advocates that professional healthcare education must become even more important for a systems-wide approach to handling hospice palliative and end-of-life care in order to ensure that the soaring numbers of dying Canadians receive quality care in all settings where they die over the next 10 years. Recognizing this critical societal need and addressing it as an educational challenge, this grounded theory study examines undergraduate student experiences with high fidelity simulation labs in death education or interprofessional palliative care. This study is guided by the central questions: What forms of knowledge and processes of learning are generated in an interprofessional palliative care simulation learning environment? And what is the experience and impacts of the interprofessional palliative care simulation from the undergraduate healthcare learner’s perspective? This research study recognized that learner participation in the instructional technological platform of simulation prompts questions about the nature of experiential learning and how it is that learning arises out of simulation. The design for this study followed standard processes in grounded theory by using constant comparisons throughout the data analysis process and by adopting a constructivist perspective toward the research process. Nine participants, all enrolled in an Ontario university and accredited an Introduction to Palliative Care course, completed two palliative care simulation lab experiences designed to provide opportunity to test drive their knowledge using a palliative approach, and to start a conversation about their role as future palliative care practitioners. The data were collected from student group debrief sessions following the simulation labs; from the study’s 3 phases’ interviews that each participant individually engaged in (each participant x 3 interviews); and finally, from my own extensive observations and field note journals. Analysis followed grounded theory procedures and initial, focused, axial and theoretical coding was performed. The substantive emergent theory is an explanatory model to address the studied phenomenon: the undergraduate interprofessional palliative care learning experience using high fidelity simulation. This new theory, 3H of Head, Heart & Hands, attempts to capture the student experience in simulated death education as it pertains to learning processes, perceptions of learning, impacts on learning, and meanings associated with learning that resulted from their participation in the study. The findings and 3H theory that emerged have significance and implications at individual, organizational, and societal levels of analysis pertaining to the fields of simulation in higher education, undergraduate interprofessional programs, and palliative care of the dying and their families.