Table 2.
Instructional strategies
| Strengths | Challenges | Examples | |
|---|---|---|---|
| Experiential learning | Training experience in real-life settings or simulated bedside formats has potential to enhance real-life work | • Requires time during busy clinical/inpatient days | Simulated patient/video playback; structured home visits; mentored hospice visits; Memorial Sloan Kettering Cancer Center's Comskills |
| • Requires availability of qualified local providers | |||
| Group didactic opportunities | Foundational peer settings allow shared insight and learning experiences with one another (social and cognitive congruence) | • Requires curricular commitment of training center | Small-group EOL communication training sessions; palliative care rotations with peer discussion groups |
| Shared learning among care disciplines | Helps learners envision patient's experience within context of multiple needs; teaches learners to develop patient strategies for utilizing wide array of resources/support | • Requires availability of multidisciplinary team representation | Joint consultations; family meetings with multiple care teams present; interdisciplinary grand rounds; clinical teaching conferences |
| Bereaved family members as educators | Provides unique perspective as family members share “lived experience” to facilitate palliative care discussions | • Requires special attentiveness to minimize emotional burden to bereaved family member | Bereaved parent panels at conferences; single sessions with bereaved family members and limited staff members; bereavement reunions hosted by hospitals |
| EOL training programs | Enables access to a structured, modular curriculum with teaching grounded in evidence base | • Requires funding for programmatic development | American Association of Colleges of Nursing ELNEC train-the-trainer program; Integrating Palliative Oncology Care into DNP Education and Clinical Practice; EPEC program; Center to Advance Palliative Care leadership training; and global examples from Portuguese Catholic University, University of Cape Town, and Mildmay Program in Uganda |
| • Requires protected time for learners | |||
| Online learning | Expands access through flexible teaching formats, protects participants’ travel resources, allows learners to receive training at their own pace and location, adapts to a “social media” learning generation | • Requires access to Internet technology; ideally fosters ways for technology to translate into mentored patient care opportunities | International Children's Palliative Care Network's free eLearning modules |
| Learner networks | Expands trainee learning opportunities, networks, and collaborations, while minimizing programmatic redundancies | • Often requires access to blogging, document and resource sharing, eGroups, and listservs | Regional SIG; National Hospice and Palliative Care Organization member-exclusive professional community; collaborative journal clubs; joint case study teaching seminars |
Abbreviations: EOL, end of life; ELNEC, End-of-Life Nursing Education Consortium; DNP, Doctor of Nursing Practice; EPEC, Education in Palliative and End-of-life Care; SIG, Special Interest Groups.