Man Dying

PROJECT AIMS:

The trigger for the project came out of my (currently nearly completed) doctorate. This is exploring hospital nurses experience of providing end-of-life care and one of the findings uncovers issues around nurses’ end-of-life knowledge. End-of-life care is known to be unpredictable due to the fluctuating changes in the patient’s condition, unpredictable events, and constantly changing situations. My study suggests the objective technical rational (TR) approach to knowledge is helpful in end-of-life care as a skills based approach; to know what drugs to give; when and how to use a syringe driver; how to manage symptoms and organise a rapid discharge home. However, there is potential for education in the form of professional artistry (PA) to complement technical rational knowledge. Professional Artistry is based on principals that can be formulated as practice develops (Fish, Coles 1998). Improvisation and refining and updating ‘on the hoof’ are part of a PA approach to practice which makes this approach more suited to ‘messy, unpredictable, unexpected situation’ (Fish, Coles 1998 p.g. 36).

Syringe driver

This project uses Professional Artistry approach with Active Blended Learning (ABL). Active learning is defined as “anything that involves students doing things, and thinking about the things, they are doing” (Bronwell, Eison 1991 p.g. 2).  Blended learning is an integration of different online and face to face methods of learning (Alammary 2019).  Active Blended Learning can therefore be described as integrated approaches to learning that are student centred, focusing on activities that support the development of the subject knowledge. This project aims to use ABL and a professional artistry approach to end-of-life education.

The project will develop two learning units on end of life care. Students may encounter a situation where a patient who is at the end of their life wishes to express their care decisions. These are advice directives and learning in practice may provide a task approach, but students need to be guided by deeper understanding; the legalities; human rights; ethics; principals; communicating any decisions. The project will provide additional learning using an online platform regarding advance care plans and decisions. This will supplement and support the students practice knowledge, developing a deeper, more intuitive and principled based PA understanding of patient decision making in end-of-life. Similarly Do Not Attempt Cardiac Pulmonary Resuscitation (DNACPR) can cause confusion with understanding among students in end-of-life care and a similar approach using professional artistry and ABL will be used to address this.

EVALUATION

The outcomes of the project will be evaluated using a summative approach to evaluation research. This will investigate the students use and engagement of the education programme as well as the quality of the learning and if the students have had any demonstrable effects on their understanding of the key topics and end-of-life practice.

   

PROJECT SO FAR

The learning resources will be developed using XERTE with the aim that they can be accessed by students at any point in their course, triggered by a demand in learning from the student. The support for the development of the XETRE has been given by Anne Misslebrook from the University Learning Technology team. Anne has been invaluable in giving me ideas as to how the overall learning could be structured.