The use of simulation-based learning to increase the confidence level of oncology advanced practice providers when discussing palliative care.

Abstract

265 Background: The increase in cancer cases globally has dramatically strengthened the need in introducing palliative care upon a cancer diagnosis. Oncology advanced practice providers (APPs) are essential in integrating palliative care concurrently with treatment. SinceAPPs have limited to no hands-on training in palliative care, they often feel unprepared and less confident in discussing palliative care with cancer patients, resulting in a gap in care. This can result in a decreased in quality of life (QoL), absence of symptom management, increased healthcare costs and usage of healthcare resources, increased emergency room visits and hospital admissions. This quality improvement (QI) project sought to increase the confidence level of APPs, when discussing palliative care using simulation-based training in an effort to address this educational gap and provide palliative care support alongside standard of care. Methods: The project utilized a sample of 15 APPs working in an academic outpatient oncology facility. Participants completed a pre-and post-survey consisting of 12 Likert-type questions to measure their confidence level in palliative care before and after the simulation training session. Simulation-based learning with standardized participants (SPs) was utilized to increase the confidence level of APPs in the outpatient oncology setting. A pancreatic cancer patient case was utilized for the simulation. The Wilcoxon’s signed-rank test was used to compare the results of the pre and post test scores. Results: The results showed positive changes between the pre- and post-survey results in confidence level. Post-survey results were statistically significant (p value of < 0.05) and respondents reported greater confidence following the simulation-based training. Referrals also increased to palliative care post simulation. Conclusions: Palliative care simulation with SPs closed educational gaps and improved the APPs confidence levels when discussing palliative care with cancer patients. As a result, simulation-based learning is an effective strategy to train newly hired oncology APPs or enhance skill deterioration as needed to integrate palliative care concurrently with treatment as the standard for cancer patients. Furthermore, from this QI project, a computer-based module was developed for new oncology APPs onboarding to the organization. Future directions are to expand to non-oncology APPs that directly care for cancer patients.