Patient Care Situations Research Articles

Taking the next step: How student reflective essays about difficult clinical encounters demonstrate professional identity formation.

Difficult clinical encounters pose emotional and behavioural challenges for medical students. Unless resolved, they threaten students' professional competence and well-being. Learning how to humanistically interact with patients perceived as "difficult" is an important component of the developmental process that underlies professional identity formation (PIF). This study used thematic analysis to examine reflective essay data from the same set of students (N = 69), first in their third year and then in their fourth year of training at a US public medical school. Analysis focused on how student perceptions of patients', preceptors', and their own behaviour, attitudes, and emotions in difficult patient care situations evolved over time, and how such evolution contributed to their professional growth. Students identified clinical predicaments influenced by their own emotions and behaviour, as well as those of patients and preceptors. In response to patients perceived as angry, rude, and uncooperative, students described themselves and their preceptors primarily as engaging in routine medical behaviours, followed by expressions of empathy. These encounters resulted in residual emotions as well as lessons learned. Fourth-year students reported more empathy, patient-centeredness, and patient ownership than third-year students. While student-physicians grew in professionalism and compassion, they also noted unresolved distressing emotions post-encounter. From third to fourth year, medical students undergo a process of professional growth that can be documented at a granular level through their perceptions of themselves, their patients, and their preceptors. Despite positive professional growth, students' lingering negative affect merits attention and support from clinical teachers.

Systematic review on interprofessional education for pre-licensure nursing student in East Asia

Purpose: This study aimed to identify and evaluate interprofessional education (IPE) interventions for healthcare professional students in East Asian countries.Methods: The reporting of this study followed the Preferred Reporting Items of Systematic Reviews and Meta-Analysis guidelines. A literature search was conducted using seven electronic databases: PubMed, EMBASE, CINAHL, Scopus, Web of Science, ERIC, and ProQuest Dissertations & Theses Global. Joanna Briggs Institute Critical Appraisal Checklists were also used to appraise the quality of the included studies. The outcomes of IPE interventions were classified based on a modified Kirkpatrick model.Results: This review included 30 studies predominantly conducted in Singapore, South Korea, and Taiwan. The prevalent research design was a one-group pre–posttest design, and most IPE interventions occurred as single events. Approximately 70% of the studies involved students from two healthcare professions, mainly nursing and medicine. Simulations, group discussions, and lectures have emerged as the most common teaching methodologies, with almost half of the studies leveraging a combination of these techniques. The IPE content primarily focused on interprofessional teamwork, communication, and clinical patient care situations; these included the management of septic shock. The effectiveness of the IPE interventions was mainly evaluated through self-reported measures, indicating improvements in attitudes, perceptions, knowledge, and skills, aligning with Level 2 of the modified Kirkpatrick model. Nonetheless, the reviewed studies did not assess changes in the participants’ behavior and patient results.Conclusion: IPE interventions promise to enhance interprofessional collaboration and communication skills among health professional students. Future studies should implement rigorous designs to assess the effectiveness of IPE interventions. Moreover, when designing IPE interventions, researchers and educators should consider the role of cultural characteristics in East Asian countries.

Development and application of energy-efficient medical beds based on IoT for patient monitoring

Later logical accomplishments and mechanical progresses have brought forward a gigantic show of modern or overhauled restorative gadgets, empowered with highly evolved embedded-control capacities and interactivity. From the ultimate decade of the 20th century, restorative beds have specifically been motivated through this surge, taking on unused shapes and capacities, whereas obliging to installation properties that have gotten to be famous for those gadgets. The beyond fifteen a long time have too delivered ahead modifications to conceptual systems, concerning the item plan and fabricating forms, As properly as the persistent viewpoints on patient-care situations and openness. This paper offers the components and the steps of design and implementation of electric medical bed supplied with monitoring devices and various sensors working together to give the Arduino a full report about the conditions of patient and according to this report the right decisions can be taken. The principles of internet of things (IOT) are applied to achieve this instrument. The paper primarily focuses on the objectives, components, and functionality of the system, such as monitoring physical parameters, detecting emergencies, reducing workload, and communicating with caretakers.

Development of the Jefferson Scale of Empathy for Teachers (JSE-T) to Measure Empathy in Educationally Relevant Situations

The Jefferson Scale of Empathy is one of the most commonly used scales in medical education to measure empathy. It is specific to the field of medical education and geared toward orienting medical students to physician empathy in patient care situations. The scale was transferred to the educational context in teacher education. In doing so, the questionnaire was reduced from the original 20 items to 9 because of content and methodological issues. A CFA showed good model-fit parameters for a three-factor model, and correlations with the German version of the Interpersonal reactivity Index were in line with the magnitudes reported in previous literature. In total, the JST-E scales show evidence for their factorial and convergent validity and their reliability. The JSE-T proves to be a good instrument for measuring empathy in educational contexts and thus closes the gap between trait measurement procedures such as the IRI and concrete-situational judgment tests, so that an economical, multidimensional testing of empathy becomes possible.

HEALTHCARE FROM THE CLASSROOM TO CLINICAL PRACTICE

Background: Nurses work in the fields of health promotion, disease prevention, treatment, and rehabilitation. After finishing high school, the title of nurse-technician is obtained, and they can be employed in primary, secondary, or tertiary healthcare institutions in basic medical care jobs up to the complex requirements of progressive care. The ability to transfer theory from the classroom to clinical practice is a key skill in nursing education. This transfer refers to students' ability to adapt classroom knowledge to different clinical practice situations. In order to provide nursing care that meets the standards of professional care, medical school students must accurately and effectively transfer theoretical knowledge to address specific patient care situations. Nursing education programs prepare students through a variety of learning opportunities that include simulated situations in healthcare offices and real-world situations in clinical hospital settings. Education takes place in classrooms, laboratories, and clinics. While the classroom environment provides students with mostly theoretical information, the clinical environment provides opportunities to put theoretical information into practice. Aim: To show the importance of practical teaching in the education of nurses. Method: Literature review, synthesis, and extraction of key professional and contemporary literature. Conclusion: Medical school students can acquire quality skills for patient care to the extent that they are able to implement them through theoretical knowledge in the clinical environment.

Prevalence and predictors of depressive symptoms among caregivers of patients with epilepsy in Hong Kong

Study aimTo estimate the prevalence of high caregiving burden and depressive symptoms among caregivers (CG) of patients with epilepsy (PWEs) in Hong Kong and identify risk and protective factors for both outcomes after the Model of Stress and Carer Burden (MSCB). MethodsThis cross-sectional study recruited participants from local epilepsy clinics to complete a 15-minute survey on a tablet. Caregiving burden (CB) was assessed using the 4-item Zarit Caregiver Burden Interview. Depressive symptoms were assessed using the 2-item Patient Health Questionnaire. Family functioning was assessed using the Short-Form Family Assessment Device General Functioning Subscale. Sociodemographic data of the caregivers and clinical data of the PWE they cared for were described. Hierarchical logistic regression models were used to analyze the factors associated with the outcomes. ResultsA hundred and fifty-one CGs of PWEs were recruited for this study. The prevalence of high caregiving burden (ZBI-4 > 7) for CGs of PWEs was 58.9% (n = 89), whereas the prevalence of high depressive symptoms (PHQ2 > 2) was 23.8% (n = 36). Hierarchical logistic regression analysis revealed that entering patient characteristics and care situations did not enhance the model’s predictability. In the full model, a high perceived CB was a risk factor for elevated depressive symptoms. Good physical health protects against depressive symptoms. ConclusionsAmong caregivers of PWE in Hong Kong, a high perceived caregiving burden was a risk factor for elevated depressive symptoms; however, the clinical characteristics of the PWEs were not. Self-reported physical health is a protective factor against increased depressive symptoms.

Sedation Practices of Mechanically Ventilated Patients During Critical Care Transport

ObjectiveMechanically ventilated patients who receive deep levels of sedation have high mortality rates, longer lengths of stay, and longer duration of mechanical ventilation in the intensive care unit. Prior literature demonstrated a high frequency of deep sedation across all levels of care. Benzodiazepines have been attributed to similar morbidity and mortality findings. MethodsThis study was a descriptive retrospective review of mechanically ventilated adult critical care transport patients from January 1, 2019, to March 11, 2020. Our primary outcome was the percentage of patients who were deeply sedated at handoff to the receiving facility. Deep sedation was defined as a Richmond Agitation Sedation Scale of −3 to −5. Our secondary outcomes were the percentage of patients who received benzodiazepines; the number of unplanned extubations, crew injuries, and unsafe patient care situations; and the incidence of ventilator dyssynchrony. ResultsFive hundred fifty-three mechanically ventilated patients were transported. Ninety-three patients were excluded because they received paralytics during transport. Four hundred sixty patients were included in the analysis, 422 (91.7%) of whom were deeply sedated. Benzodiazepines were administered to 141 patients (30.6%). There were no differences observed in the secondary outcomes. ConclusionDeep sedation and benzodiazepine administration were frequent during critical care transport of mechanically ventilated patients.

Does the clinical experience of a tutor influence how students learn extended focused assessment with sonography for trauma: A randomized controlled trial

Background Extended focused assessment with sonography for trauma (eFAST) is now an essential part of the primary survey of an emergency patient. The discrepancy between an increasing number of medical students and growing clinical commitments of lecturers is a major challenge in student teaching that needs to be resolved. The practice of using peers in the clinical education of medical students is a well-established tradition and commonly practiced but lacks definition in its implementation. Therefore, we aimed to investigate whether the level of experience of the tutor affects the effectiveness of learning among students using eFAST during a clinical scenario. Methods A prospective randomized single-blinded controlled trial, where 168 medical students in the eighth semester were randomized into control and intervention groups. The control group received the 4-h standard ultrasound (US) tutorial from various resident doctors. All residents were at least stage-1-certified in ultrasound. The intervention group received the tutorial from trained peer teachers (TPTs). These TPTs were medical students who were qualified to teach the procedure. All students received an initial tutorial on basic ultrasound principles and a final lecture on recognizing pathological images. Students completed basic questionnaires requesting pre-existing US experience, theoretical and clinical application questions based on eFAST one day later and at the end of the semester. Students also completed a 6-min OSCE (Objective-Structured-Clinical-Exam) station involving clinical emergency scenarios. Results Eighty-five percent of participants had no previous eFAST experience. Early and later evaluation of the participants show no significant differences between both groups regarding the theoretical and the clinical application examinations, except the early phase OSCE results, which was not repeated in the late-stage results. Conclusions Peer-teaching can be utilized to teach practical skills such as eFAST without a loss of clinical application skills. This relieves the burden of removing doctors from patient care situations and maintains teaching standards.

Evolving the Assessment of Clinical Judgment: An Individual or Collective Competency?

Nurses make decisions about care individually and as part of a team. Collective competence, the effective team management of patient care situations, is partially dependent on nurses' individual confidence and clinical judgment competence. To describe individual and team-based facilitators and barriers to collective competence in teams of senior baccalaureate-level prelicensure nursing students during a team-based simulation. With a cross-sectional design, the study used a 26-item survey based on the National Council of State Boards of Nursing (NCSBN)-Clinical Judgment Measurement Model (CJMM) (α= .86) to assess individual student confidence and perceptions of clinical judgment competence while observation of team dynamics and task completion assessed collective competence. Closed-loop communication and role assignment were facilitators of collective competence when present and barriers when absent. Additional barriers were lack of student confidence and perceived competence with Layers 3 and 4 of the NCSBN-CJMM. Team-based simulation strategies can be effectively used to assess collective clinical judgment competence.

Updated AHA Basic and Advanced Cardiac Life Support guidance with COVID-19 considerations.

:The American Heart Association released an updated Basic and Advanced Cardiac Life Support guidance that incorporates the latest knowledge regarding COVID-19 and its transmissibility. This article details the new guidance, including strategies for reducing provider risk and exposure and for special patient-care situations.

Special Report: Ethical Decision-Making in Contemporary Psychiatric Practice—An Evolving Challenge

Special Report: Ethical Decision-Making in Contemporary Psychiatric Practice—An Evolving Challenge

Critical thinking dispositions’ level among neophyte nursing students

Introduction: Critical thinking dispositions (CTD) are valued across the health professions disciplines being essential for decision-making, critical judgment and managing complex health situations. Promoting critical-thinking dispositions in undergraduate nursing students can support the students to utilize critical thinking during challenging patient care and problem-solving situations.
 Objective: This study aimed to assess the level of critical thinking disposition among neophyte nursing students in a private nursing college.
 Methodology: An analytical cross-sectional study design was adopted. Neophyte students (n=98) of the BSN program participated in the study. Critical Thinking Dispositions Scale (CTDS) of 54 items under seven constructs was utilized to assess CTD level. Data was analyzed at descriptive and inferential level using SPSS 23.0 version. 
 Results: Overall, CTD among neophytes nursing students is at 75% a progressive level. Contextual and inquisitiveness construct of CTDs are at positive CTD level while other constructs are at the progressive level. Students have completed their matriculation from public 55(56.1%) while FSc (Faculty of Science) from private sector 57(58.2%). Mothers of most neophytes 73(74.5%) were housewives and fathers were working in private organization 32(32.7%). There was no statistically significant association between CTD’s construct with demographic variables (P-Value, >0.05). FSc marks showed a significant association with overall CTD scores, intellectual and inquisitiveness, while admission entry test scores associate significantly with intellectual construct.
 Conclusion: The CTD level of neophyte is at a progressive level which suggest that different teaching and learning strategies could be implemented to improve this level.

Hospital nurses' moral distress and mental health during COVID-19.

AimsTo explore factors associated with nurses' moral distress during the first COVID‐19 surge and their longer‐term mental health.DesignCross‐sectional, correlational survey study.MethodsRegistered nurses were surveyed in September 2020 about their experiences during the first peak month of COVID‐19 using the new, validated, COVID‐19 Moral Distress Scale for Nurses. Nurses' mental health was measured by recently experienced symptoms. Analyses included descriptive statistics and regression analysis. Outcome variables were moral distress and mental health. Explanatory variables were frequency of COVID‐19 patients, leadership communication and personal protective equipment/cleaning supplies access. The sample comprised 307 nurses (43% response rate) from two academic medical centres.ResultsMany respondents had difficulty accessing personal protective equipment. Most nurses reported that hospital leadership communication was transparent, effective and timely. The most distressing situations were the transmission risk to nurses' family members, caring for patients without family members present, and caring for patients dying without family or clergy present. These occurred occasionally with moderate distress. Nurses reported 2.5 days each in the past week of feeling anxiety, withdrawn and having difficulty sleeping. Moral distress decreased with effective communication and access to personal protective equipment. Moral distress was associated with longer‐term mental health.ConclusionPandemic patient care situations are the greatest sources of nurses' moral distress. Effective leadership communication, fewer COVID‐19 patients, and access to protective equipment decrease moral distress, which influences longer‐term mental health.ImpactLittle was known about the impact of COVID‐19 on nurses' moral distress. We found that nurses' moral distress was associated with the volume of care for infected patients, access to personal protective equipment, and communication from leaders. We found that moral distress was associated with longer‐term mental health. Leaders should communicate transparently to decrease nurses' moral distress and the negative effects of global crises on nurses' longer‐term mental health.

The Impact of Simulation-Based Learning on Undergraduate Nursing Students’ Satisfaction and Self-Confidence at the Sultan Qaboos University in Oman

Simulation-based learning has been implemented in nursing education to help students experience the real world of nursing, increase their self-confidence, and allow them to practice safely. Through simulation practice, students can be exposed to different patient care situations without waiting for opportunities to arise at their clinical placement. This study aims to explore students’ satisfaction and self-confidence as learning outcomes associated with the simulation experience through the lens of the Jeffries theoretical framework. A descriptive correlation study was conducted from October to December 2020 at the College of Nursing in Sultan Qaboos University in Oman. A convenience sample of 52 nursing students in their fourth and fifth academic year were recruited for the study. Student satisfaction and self-confidence in learning instrument was adopted from the National League for Nursing (NLN, 2006). The Statistical Package for the Social Sciences (SPSS) version 26 was used to analyze the data. Overall, the respondents from both academic years were satisfied with simulation practice as a learning method, and students’ self-confidence was found to improve by learning through simulation practice. No significant relationship was found between students’ satisfaction and demographic data, including age and gender. Students’ self-confidence was found to have a significant relationship with students’ age only. The results of this study indicate that simulation-based learning is an effective method in nursing education. Keywords: simulation-based learning, undergraduate nursing students, simulation impact DOI: 10.7176/JEP/12-9-11 Publication date: March 31 st 2021

Real-Time Bedside Root Cause Analysis (RCA) as a Catalyst for Clostridioides difficile Reduction

Background:C. difficile infection has been a significant cause of morbidity and mortality over the past decade. Our hospital had rates of hospital-onset, laboratory-identified, C. difficile infection (HO-CDI) that were significantly higher than our state and national benchmarks. HO-CDI is defined as a test positive for C. difficile occurring on or after day 4 of hospitalization, regardless of the presence of symptoms. New leadership at the hospital sought a creative way to engage staff in finding solutions to our high rates of HO-CDI. Objective: The purpose of this intervention was to engage frontline staff in reporting and solving patient care situations that may increase infection risk to decrease HO-CDI rates. Methods: Starting in July 2015, real-time bedside RCAs were performed weekly for any HO-CDI on the unit to which the infection was attributed and on any unit from which the patient had been recently transferred. Top clinical leadership of the hospital, and all services and departments, physicians, nurses, and others involved with the patient’s care were expected to attend and identify factors that may have contributed to the infection. The findings were documented, and changes to care were made based on the findings. The rate of incident hospital onset HO-CDI per 10,000 patient days was used to measure outcome because standardized infection ratios for the period before 2016 were not available. Results: Staff members suggested 6 specific actions that were undertaken to decrease HO-CDI risk (Table 1). The HO-CDI rate during the preintervention period (2012–2014) was 6.85 per 10,000 patient days (275 cases). In the postintervention period (2016–2018) the HO-CDI rate was 3.13 per 10,000 patient days (101 cases). There was a 54% reduction in the HO-CDI rate in the postintervention period (P < .001). Conclusions: The multidisciplinary bedside RCA process resulted in staff providing recommendations for actions to reduce HO-CDI risk. Implementation of staff suggestions resulted in a sustained, significant decrease in HO-CDI.Funding: NoneDisclosures: None

FSHD / OPMD / MYOTONIC DYSTROPHY: P.237 Survey of patient care situations for congenital/childhood onset myotonic dystrophy in Japan –Nationwide patient survey

Myotonic dystrophy (DM) is an autosomal dominant inherited disorder, often familial. As patients have diverse symptoms, health support needs differ but research is lacking on MD management in Japan. A nationwide survey of medical care and treatment for MD patients, including those with neonatal to adolescent onsets, was conducted in 2018. Respondents were registered in the Japanese national registry (Remudy) or were recruited by doctors specializing in neuromuscular diseases. We obtained 342 valid responses for 813 questionnaires, including 87 with congenital / childhood onset. We divided respondents into 3 groups by onset age: group 1, 28 patients (8.2%) ˂4 weeks, group 2, 4 (1.2%) ˂12 months, and group 3, 55 (15.5%) 1-19 years. There were no gender differences. Average patient ages at survey were 12.5, 25.4, and 31.5 years, and the response ratio of patients having a family history of DM were 71.8%, 100%, 60%, respectively. Group 1 had clinical symptoms at birth including asphyxia, while group 3 tended to show myotonia symptoms leading to DM1 diagnosis. Finger dysfunction and fatigability were common chief complaints in groups 1 and 3 (response ratio ∼70% in group 1 and ≥95% in group 3). Over 80% of group 1 but only 31% of group 3 patients required rehabilitation. More than one third of respondents in each group were dissatisfied with health support or medical care. We found that 16% of respondents had no chance to consult neuromuscular specialists because of distance or they lacked information about such specialists. We ascertained patients’ actual conditions, at different ages, and with different clinical types. Since necessary information and health support systems vary according to patient growth, development and disease evolution, appropriate medical services should ideally be provided whenever needed. This valuable information could contribute to provide MD patients standardized medical services.

Two critical thinking models-probing questions and conceptualization-adding 4 skillsets to the teacher's armamentarium.

Critical thinking is ubiquitous in patient care. One track for critical thinking develops skillsets emulating the thought process of the master clinician using probing questions and has been offered in treatment planning, literature search, and critique, risk assessment in caries and geriatrics, technology decision-making, EBD, and IPP. This paper offers 2 additional critical thinking skillsets following this emulation model in social work and ethics. Conceptualization, another form of critical thinking, is also ubiquitous in health care, yet almost no literature exists to guide learning and assess performance on conceptualization. This paper introduces for discussion 2 examples of conceptualization-"How and how much does this situation differ from the ideal?" and "How does the student/practitioner conceptualize the outcome prior to the imminent procedure?" -used continually by the practitioner in patient care situations. The result is 4 additional critical thinking skillsets at different stages of development in the armamentarium for the teacher.

Moral Distress: Defined and Described by Neonatal and Pediatric Critical Care Nurses in a Quaternary Care Free-Standing Pediatric Hospital.

Despite a growing population of chronically and acute critically ill neonatal and pediatric patients, there were few published articles related to moral distress as experienced by nurses caring for these patients. The aim of this study was to define moral distress based on the perceptions and experiences of neonatal and pediatric critical care nurses. A qualitative descriptive study using focus group methodology was undertaken. All nurses with 2 or more years of experience from the 4 neonatal and pediatric intensive care units in a large 404-bed urban pediatric hospital located in the northeast were invited to attend 1 of 15 audio-recorded focus groups lasting 60 to 90 minutes. Once data were transcribed, conventional content analysis was used to develop the definition and categories of moral distress. Nurse participants defined moral distress as "patient care situations where there is a mismatch or incongruity between expected behaviors of the nurse and his/her personal values/beliefs in the neonatal/pediatric critical care setting." The 2 overarching categories that emerged from the data were patient-focused factors and nurse-focused factors. Understanding how neonatal and pediatric critical care nurses define moral distress and what contributes to its development is foundational to developing targeted strategies for nursing support and education, with the goal of creating a culture of moral resiliency.

Using Declining Patient Condition Simulations in the Radiation Oncology Outpatient Setting to Improve Clinician Responses

Patient acuity and the complexity of ambulatory procedures are increasing across the spectrum of healthcare in the United States. This trend is no different in radiation oncology, where patients experience emergent issues. While many of these issues can be prevented, thus avoiding emergency situations, most education only focuses on identifying and responding to the most emergent clinical situations. Patients who are declining are at increased risk of advancing to emergent conditions because of the lack of evidence-based guidelines to prevent further clinical decline. The purpose of this quality improvement project was to improve the knowledge and comfort level of the care team in responding to urgent patient care situations in the ambulatory radiation oncology setting. The authors hypothesized that institution of a formal educational program would lead to an improvement in comfort level in both identifying and managing declining patients. An inter-professional educational plan was developed to shift focus from emergent scenarios to focus on declining patients. As part of that education, simulations were developed using examples of actual clinical situations, and focused on preventing patients from further declining into emergent conditions. The plan included quarterly didactic, inter-professional education and hands-on simulations. Pre- and post-assessment surveys, using a 1-5 Likert scale measured comfort levels of clinicians before and after the intervention. Post intervention, results were statistically significant for the ability of team members to identify adverse reactions (Mean difference [MD] 0.76, p=.028), care for declining patients (MD .67, p=.044), manage airway decompensation (MD 0.93, p=.023), know their role in a crisis (MD 0.81, p=.009), understand the role of other team members (MD 0.73, p=.028), and know specific items used to intervene when a patient is in crisis (MD 1.55, p<0.001). There was no statistically significant difference in respondents’ comfort level in recognizing a deteriorating patient, caring for a patient who did not require code team assistance, or managing patients with seizures. However, all three measures demonstrated a trend towards improvement. Until recently, the focus in ambulatory settings had been the practice of emergencies and code blue scenarios. As patient acuity and care complexity increase in these settings, clinicians can benefit from review of urgent care and scenarios of patients deteriorating that focus on the broader scope of care. Results of this project indicate that, while educating interprofessional staff to recognize patients who are deteriorating is important, a focus on the importance of team dynamics is equally important. The implication of this project is that formal training on recognition and management of declining patients is beneficial in the ambulatory setting to build staff comfort.

Innovative Education for the Development Competencies in the Care of People at the End of Life and Their Family Caregivers

The attention to people with advanced chronic disease requiring palliative care. It takes increasingly importance within the health system, the demands of patients and their families and the interest to avoid suffering of progressive sensitivity in their approach. The need of professional to management patient care situations in the end of life several times results difficult to extend that health professional are unprepared to lead effectivily the emerging feelings caused as a result of the care relationship. To evaluate the effectiveness of an innovative education strategy for undergraduate and graduate students in the development of cognitive and systemic competences in the care of people at the end of life and their family caregivers. Ninety students participated in this study of mixed descriptive design; Two questionnaires on cognitive and systemic competencies were completed before the intervention and the beliefs and perceptions regarding the care of patients in palliative care and their families were explored. After the intervention, the cognitive and systemic competences were evaluated; We again explored beliefs and perceptions regarding palliative care. The intervention fulfilled the expectations regarding the development of competences, emphasizing social skills, active listening, empathy and communication as central elements in the formation of palliative care. Participants reported high levels of satisfaction with the innovative education strategy. The innovative education strategy in palliative care is effective for the development of cognitive and systematic competencies, it is appropriate by students and its low-cost become attractive to educative institutions with limit resources. Learning in meaningful practice scenarios is a mechanism for students to strengthen their communication skills and determine the need for authentic presence in the care of people in advanced stages of illness and their families.