Evidence informed generalist palliative care content for undergraduate nursing curriculum: An integrative review

Background: Clinicians delivering palliative care require the specific knowledge, skill and understanding to meet the needs of the dying. Research shows that undergraduate nursing students report feeling inadequately prepared to provide safe and effective palliative care. Objectives: To identify existing empirical evidence on generalist palliative care content within international undergraduate nursing curricula and to synthesize existing generalist palliative care topics. Design: An integrative systematic review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered with the International Prospective Register of Systematic Reviews (PROSPERO). Data sources: Keywords were searched in six electronic databases CINAHL, Medline, APA PsycINFO, SCOPUS, Cochran Library and ProQuest Nursing & Allied Health Database, between January 2000 and February 2022. Review methods: Studies were selected as per a pre-determined inclusion and exclusion criteria. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Tabulation of the author, year, country, aim, participants and setting, method, generalist palliative care content topics, additional findings and limitations were compiled. A thematic analysis of the data was conducted to organise and categorise generalist palliative care topics into an additional table followed by a narrative synthesis. Results: Of the n = 1014 papers retrieved, n = 13 studies of varying methodological quality were included in the analysis (n = 8 quantitative descriptive, n = 5 mixed method). Most studies were published in high income countries with developed economies. Methods used to obtain data include survey, extraction of secondary data and expert consensus. Generalist palliative care topics were presented as a list reporting frequency taught/discussed/cited (n = 10), recommended competencies (n = 2), and teaching modules (n = 1). A large variety of topics were identified with differing levels of detail and clear differences in topics identified globally. Overall, the most frequently mentioned generalist palliative care topics were pain and symptom management (n = 12), grief loss & bereavement (n = 12) and communication (n = 11). Conclusions: This review demonstrates for the first time that international primary research evidence on generalist palliative care content in undergraduate nursing curriculum is minimal, of varying methodological quality, with visible inconsistencies among studies designed to inform curriculum verses studies reporting what is taught to students. More research is required to create evidence informed generalist palliative care content for undergraduate nursing curriculum. Recommendations: It is recommended for future research to use international consensus-based methods to inform and develop internationally agreed educational topics to optimise patient care at the point of nurse registration.