Abstract

Background: Nurse practitioners (NPs) work in a wide array of healthcare settings, including hospitals, primary care clinics, long-term care facilities, and specialty clinics. Historically very few nursing programs and nursing texts offered content related to EOL care (D’Antionio, 2017). At the graduate level, the American Association of Critical Care Nurses (AACN) Essentials contain elements of EOL care such as effective communication and professionalism, but do not explicitly delineate it as a distinct competency or sub-competency (AACN, 2023). Previous research found that most NP programs offer little to no instruction on palliative care and that palliative care training for nurses remains limited (Jensen-Seaman & Herbert 2016; DeSanto et al., 2020). As a result, nurses often lack adequate preparation in EOL topics and, in many cases, learn while on the job. Therefore, nurse practitioner programs should be active in preparing future nurse practitioners to handle caring for patients at the end-of-life stage.

Purpose: To determine the status of end-of-life education in nurse practitioner programs in the United States.

Method: The study was a cross-sectional, observational study of all nurse practitioner program directors in the United States accredited by the Commission on Collegiate Nursing Education (CCNE) as of December 2023. Online surveys were used to disseminate a multi-wave survey to program directors.

Results: A total of 92 of 399 directors returned completed surveys (23.1%). Although directors strongly believed in the benefits of integrating end-of-life care components into the curriculum, more than half (55%) reported not having a formal end-of-life curriculum in place. Another 8% had decided to implement a formal end-of-life curriculum. Thus, 63% of the programs either did not have a formal end-of-life curriculum in place or had just recently decided to implement one. Of those programs surveyed, approximately a quarter (24%) reported having a formal end-of-life curriculum in place for at least a year. Of those programs that taught end-of-life topics or skills, the majority did not formally evaluate nurse practitioners' competence.

Conclusions: Although end-of-life training of nurse practitioners is limited, there is still room for improvement. The results of this study indicate that a significant proportion of nurse practitioner programs are not providing the type of education that would help them develop competency in end-of-life care and communication.

Notes

References:

1. American Association of Colleges of Nursing. (2023). Primary Palliative Care Competency (CARES/G-CARES): Alignment with the 2021 AACN Essentials. https://www.aacnnursing.org/Portals/0/PDFs/ELNEC/Alignment-CARES-G-CARES-Essentials.pdf

2. D'Antonio, J. (2017). End-of-Life nursing care and education: End-of-life nursing education: Past and present. Journal of christian Nursing, 34(1), 34-38.

3. DeSanto-Madeya, S., Darcy, A. M. G., Barsamian, J., Anderson, A., & Sullivan, L. (2020). An innovative application of end-of-life nursing education consortium curriculum to increase clinical nurses' palliative care knowledge. Journal of Hospice & Palliative Nursing, 22(5), 377-382.

4. Jensen-Seaman, K., & Hebert, R. S. (2016). Palliative care education in nurse practitioner programs: a survey of academic deans. Nurse Educator, 41(3), 130-133.

Description

Nurse practitioners (NPs) often lack adequate preparation in EOL topics and, in many cases, learn while on the job. Therefore, nurse practitioner programs should be active in preparing future nurse practitioners. The results of this study indicate that a significant proportion of nurse practitioner programs are not providing the type of education that would help them develop competency in end-of-life care and communication.

Author Details

Derek Cegelka, PhD MPH; Jessica Nishikawa, DNP; Victoria Wagner-Greene, PhD MPH; Xavier Heidelberg, MPH

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Other

Keywords:

Hospice, Palliative, or End-of-Life, Curriculum Development, Nurse Practitioners

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

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End-of-Life Training in US Nurse Practitioner Programs: A National Study

Seattle, Washington, USA

Background: Nurse practitioners (NPs) work in a wide array of healthcare settings, including hospitals, primary care clinics, long-term care facilities, and specialty clinics. Historically very few nursing programs and nursing texts offered content related to EOL care (D’Antionio, 2017). At the graduate level, the American Association of Critical Care Nurses (AACN) Essentials contain elements of EOL care such as effective communication and professionalism, but do not explicitly delineate it as a distinct competency or sub-competency (AACN, 2023). Previous research found that most NP programs offer little to no instruction on palliative care and that palliative care training for nurses remains limited (Jensen-Seaman & Herbert 2016; DeSanto et al., 2020). As a result, nurses often lack adequate preparation in EOL topics and, in many cases, learn while on the job. Therefore, nurse practitioner programs should be active in preparing future nurse practitioners to handle caring for patients at the end-of-life stage.

Purpose: To determine the status of end-of-life education in nurse practitioner programs in the United States.

Method: The study was a cross-sectional, observational study of all nurse practitioner program directors in the United States accredited by the Commission on Collegiate Nursing Education (CCNE) as of December 2023. Online surveys were used to disseminate a multi-wave survey to program directors.

Results: A total of 92 of 399 directors returned completed surveys (23.1%). Although directors strongly believed in the benefits of integrating end-of-life care components into the curriculum, more than half (55%) reported not having a formal end-of-life curriculum in place. Another 8% had decided to implement a formal end-of-life curriculum. Thus, 63% of the programs either did not have a formal end-of-life curriculum in place or had just recently decided to implement one. Of those programs surveyed, approximately a quarter (24%) reported having a formal end-of-life curriculum in place for at least a year. Of those programs that taught end-of-life topics or skills, the majority did not formally evaluate nurse practitioners' competence.

Conclusions: Although end-of-life training of nurse practitioners is limited, there is still room for improvement. The results of this study indicate that a significant proportion of nurse practitioner programs are not providing the type of education that would help them develop competency in end-of-life care and communication.