Improving Bedside Palliative Care Through Simulation

Topic: Education Strategies

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Previous research has demonstrated that nurses face numerous challenges in providing high quality palliative and end-of-life care. Specifically, nearly half of all nurses report that they do not feel competent in delivering adequate end-of-life care, and 63% report feeling as though they had not received adequate training in end-of-life care (Betcher, 2010).

The Greenwich Hospital Palliative Care Resource Nurse training program was developed to highlight the aspects of palliative and hospice care that its nurses need to review and practice, based on data collected from a hospital-wide survey created by Dr. Donna Coletti in 2013. Two of these aspects include initiating crucial conversations with patients and family members, as well as appropriately administering as-needed medications at the end-of-life.

To support this data, a literature review of 10 articles specifically addressing palliative and end-of-life simulation was conducted, and a gap in the literature was found. The focus of the research was on nursing students and not licensed, practicing nurses. However, the literature overwhelming cited a lack of preparation of nursing students in the area of hospice and palliative care – due to lack of education, application of the information, or both (Sperlazza & Cangelosi, 2009; Ellman et al., 2012; Fabro et al., 2014; Moreland et al., 2012; Tuxbury et al., 2012; Eaton et al., 2012). It can then be assumed that the licensed, practicing nurse is ill-prepared after graduation to work with this population unless specifically trained on the job. Heretofore, the Palliative Care Simulation Program was created as an adjunct to and expansion upon the Palliative Care Resource Nurse training program. The purpose of the Palliative Care Simulation Program is to create a safe environment for clinicians to practice having crucial conversations with patients and family members in need of palliative care. The pre-test, post-test intervention study will determine the effectiveness of a palliative care simulation intervention in promoting self-efficacy of graduate nurse residents for the provision of palliative care.


  • Donna E. Coletti, MD
  • Medical Director
  • Greenwich Hospital
  • 5 Peryridge Road
  • Greenwich, CT 06830
  • (203) 531-0395


  • Cheryl Mayeran
  • Gina Trovato, Registered Nurse
  • Nicole Melshenker, Nurse Clinician

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