End of Life Care education in a novel Bi-professional small group seminar

Problem

End of Life Care (EOLC) education for medical students is increasingly becoming a responsibility of Primary Care Divisions. Guidance on the delivery of EOLC in practice, focuses on the importance of interprofessional working (DoH 2008; GMC 2010, LACDP 2014; NPEoLP 2015, HEE 2017). This is rarely emphasised in pre-registration teaching, which tends to focus on uni-professional learning. The Primary Care division at the University of Nottingham, in collaboration with the School of Nursing, organised a seminar on EOLC for medical and nursing students, and investigated use of inter-professional learning (IPL) for EOLC education.

Approach

An innovative bi-professional EOLC seminar was designed and implemented, hosting second year medical students and third year nursing students. These cohorts were selected due to timetabling and alignment of curriculum objectives. The seminar format consisted of a mixture of 10 to 15 nursing and medical students, facilitated in a bi-professional approach with one nursing and one general practice tutor. Evaluation was performed using a structured questionnaire completed at the end of the seminar. The questionnaire was based on the modified “Readiness for Inter-professional Learning Scale” (Allstaff 2006). The questionnaire contained a quantitative section (focused on: teamwork, collaboration, inter-professional learning, End of Life Care and the student’s experience of the seminar teaching), and a qualitative narrative response section regarding the learning experience of the seminar.

Findings

430 students attended the seminar, of which 202 (47%) completed the quantitative portion of the questionnaire, and 85 (19.7%) completed the narrative section. Quantitative feedback was overwhelmingly positive, with 90.6% of students agreeing or strongly agreeing that learning with medical and nursing students enhanced the seminar with similar concordance regarding; confidence speaking with patients regarding EOLC, wanting to partake in similar sessions in the future and their perception that they would be a better member of a healthcare team due to the session.The qualitative responses highlighted that both nursing students and medical students felt they gained a wider perspective on EOLC from being in a bi-professional group and that it may benefit from a broadening of the specialities involved E.g. Pharmacy students.

Consequences

Our findings demonstrate how EOLC which is high on the agenda of educational bodies can be taught using an a novel bi-professional approach. Our use of primary care tutors along with nursing tutors provided expert clinically relevant facilitation to these sessions. IPL is high on the medical school agenda and a major constraint is often timetabling large groups of students from different specialities, our study shows that using a bi-professional model of students and tutors can show positive outcomes and this model can be used by medical schools to help ensure wider healthcare perspectives are central to teaching.