Communication in a Palliative Care Setting: The Use of Shadow Box as a Strategy
Sufia Turner, RN, BN; Nicole Harder, RN, PhD
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Communicating with palliative patients and families is a fundamental yet difficult skill for nursing students to acquire. While many nursing programs didactically instruct palliative theory, actual hands on application comes with challenges. Gillett, O’Neill and Bloomfield (2016) found intrinsic and extrinsic factors were contributing to student’s inability to communicate effectively with patients and families. Intrinsic factors were those such as a lack of self-confidence and discomfort with the emotional aspect of the communication. Whereas extrinsic issues could be nurses in the field barring students from caring for palliative patients as a way to mitigate how and what is said to patients and families during such a vulnerable time. As clinical palliative care placements are becoming more difficult to find, opportunities for students to apply their knowledge and skills within the context of palliative care communication are limited (Bloomfield, O’Neill & Gillett, 2015).
In order to assist students with gaining confidence and learning what to say in these difficult and oftentimes emotional situations, we created simulation with high psychological fidelity for paediatric and adult patients. We termed these as “Shadow Box” simulation based experiences. This technique utilized video and field experts to allow for students to both simulate what to say as well as watch a demonstration by an expert of effective palliative communication. This presentation will provide an overview of the “Shadow Box” strategy, demonstrate the use of the SBE, and provide some initial feedback we received from our students.
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