Continuing Education in Palliative Care Nursing: An Exploration of Perceived Outcome and Factors Influencing Application of Learning

Many inadequacies have been identified in the delivery of palliative care in the acute hospital setting and in the provision of palliative care education. The provision of such education has tended to be sporadic and uncoordinated. Recently, more structured courses for nurses have been available. However, little attempt has been made to evaluate the outcome of formal teaching in this area. This study explores the perception of outcome of registered nurses who have undertaken the Professional Studies II Course in Care of the Terminally Ill Patient. Questionnaires, semi - structured interviews and the Critical Incident Technique were used to collect data on the application of learning and factors which influenced this. Most participants considered that the course was very beneficial to their own personal development and to their clinical practice. The confidence derived from their perception of enhanced knowledge of symptom control and communication skills were the main enabling factors. They perceived an increased ability to respond to and cope with the expression of intense emotion. They also acquired the confidence to act as an advocate for patients and relatives. As such they were able to ensure that symptoms were more adequately controlled and that information needs were met. Factors which limited their ability to apply learning and influence practice were mainly related to lack of interest and support in the work environment. The ability to argue their case from a sound knowledge base succeeded in swaying the opinion of some medical staff. However, in some respects there was more resistance from nursing colleagues. The study concludes that the impact of Continuing Professional Education in Nursing could be enhanced by: 1. identification of a 'facilitator' in the work environment. This person could ensure that the objectives of the potential candidate and the institution were compatible and help to prepare the candidate for attendance. They could also provide support and encouragement to apply and share their learning on return from courses; 2. development of closer links between the facilitator or manager and these course providers; 3. more preparation of the participants by the course providers to institute change and cope with conflict