Date of Award

Fall 12-19-2018

Document Type


First Advisor

Dr. Sheryl Winn, DNP, APRN, ANP-BC

Second Advisor

Dr. Deborah MacMillan, PhD, RNC, CNM

Third Advisor

Dr. Kelly Bouthillet, DNP, APRN, ACNP-BC


Background: The CDC (2012) reports that 1/3 of Americans have no advance care planning (ACP), which is essential for maintaining autonomy when people are no longer able to communicate wishes directly. IOM (2014) reports that providers have limited training in communication techniques and low confidence in holding advanced care planning conversations. Nursing simulation is an effective method of teaching clinical skills in a safe environment. The development of a high fidelity (HF) standardized patient simulation, using the Jeffries Simulation Framework, combined with evidence-based practice classroom curriculum, may increase knowledge and confidence in holding ACP conversations for nurse practitioner students.

Methods: A pilot study with 44 APRN FNP students that received classroom communication training using evidence-based ELNEC materials and role play opportunities. One month later students participated in a palliative care standardized patient simulation experience in a HF medical office environment. FNP students were required to communicate bad news of a poor diagnosis to a family member and begin the advance care planning conversation using the SPIKES protocol.

Results: Significant increase in post intervention ACP communication knowledge scores, self-confidence in holding ACP conversations M= 30.55, SD=2.992, 95% CI 29.64, 31.46, (Mdn= 31), range 11, 35, and satisfaction with the learning experience M= 18.14, SD= 2.11, 95% CI 17.50, 18.78, Mdn= 19, with range between 13 and 20.

Included in

Nursing Commons