CAPSTONE End-of-Life Care Course for Pre-Licensure Nursing Students

Proposal Implementation Planning Phase

Implementation Resources

Table of Contents

Human Resources

Human resources in project management focus on team recruitment, organization, and management until completion of the project. During pilot testing and implementation of the new curriculum, human resources will include the stakeholders’ team, information technologists, and students. The key stakeholders that include faculty members, executive management, and the information technologists.The executive management will ensure necessary capital is available to conduct the study. The nurse educators will be tasked with teaching students the new course and evaluating the success of the pilot study. The information technologists will be crucial during piloting to help academic nurse educators and students utilize online learning. These individuals will be available for approximately 30 hours until full completion of the pilot study. The administration will have to cater to the services provided by the project managers to ensure the success of the pilot study. Salaries for the nurse educators, information technology staff, and other team players will be necessary during piloting and actual implementation. Training of the personnel including the academic partners from the hospital will require capital to cater for trainers and organization of the training sessions.

Financial Resources

Financial resources are necessary to the purchase of appropriate equipment, services, and supplies during program implementation. These will include salaries for the ANEs and ITs, purchase of the LMS, and training materials like computers. During the pilot study, financial resources will be required to enable the utilization of the learning management system including updates on the current Canvas LMS. Consumables like markers, flip charts, and copies of the training materials will require capital. The estimated cost for the pilot study is $1000 inclusive of the salaries for the ANEs.

Technological Resources

The success of projects depends on various factors including time, cost, and effective utilization of technology. The introduction of new learning strategies and increased utilization of the online environment means that technology will be utilized. The information technology specialist will determine the effectiveness of the available LMS and make adjustments. The LMS will support the online availability of learning resources, discussions, and testing of students. An active internet will be required to ensure students have access to learning resources like journals and videos. Additionally, the IT department will ensure the installation of additional security measures to prevent breaches.

Pilot Testing Procedures

Please Refer to table 3: Task and Timeline Table

Stakeholders

Executive Management. The executive management or the administration together with the project manager will guide the pilot testing. These individuals will allocate financial resources required to guide the pilot study including resources for installation of technologies, training staff, and monitoring of the project. The involvement of the executive management will also influence the active participation of the academic educators and students to ensure the success of the pilot study.

Academic Nurse Educators. The pilot testing will involve the education of students about EOL care while utilizing active learning strategies and new technologies. A small group of students that have already taken the course will be selected for the study. To prepare the students, the ANEs will discuss introduction to the EOL care course, collaborative practices during EOL care, patient-centered care, and ethical considerations. The nurse educators will deliver content to students, guide them through simulation activities and deliver tests or assessments to gauge the student’s understanding. These members will also participate in training sessions to ensure they understand how the online learning environment is used and any new updates to the installed technology. Lastly, these members will evaluate student learning and provide insight on areas that might require improvement before the actual implementation of the new curriculum.

Information Technology Team. This team will be responsible for ensuring the functionality of the LMS and the availability of learning resources. The team will be responsible for guiding students and academic educators to utilize the online learning environment as a strategy to incorporate the new learning methods. The availability of this team will also ensure effective security measures are taken to prevent a breach of data and any form of cheating.

Academic Partners. The academic partners that will be utilized during the pilot study will include the clinical instructors and hospital charge nurses. These individuals directly interact with students during their rotation and have experience with the challenges faced. During piloting, these stakeholders will assess the ability of the students to care for patients after taking the course. Their knowledge and expertise will help guide the implementation team in any changes required to achieve expected results.

Nursing Students. The pilot testing will focus on the learner’s ability to acquire knowledge and utilize it to improve patient outcomes. The students will participate in training on how to utilize online learning platforms and simulations. During classroom learning, the students will be tasked with listening and providing feedback on areas that might require improvement. The involvement of the students will be crucial to the acceptance of the curriculum and the achievement of positive results.

Feedback Procedures

The feedback on the course content will be gathered from the academic nurse educators and the students. A focus group will be used to gather relevant information from the stakeholders. To begin with, the academic nurse educators will describe the relevance of the content to EOL care and the acquisition of necessary skills. The instructors will also describe whether the content was easy to deliver including the ability of the students to understand. A formative assessment test for the students during piloting will enable the instructors to understand the student’s ability to grasp key concepts of the topic. The second approach will involve gathering feedback from the clinical instructors regarding the students’ capabilities upon learning. The instructors will assess the knowledge gained and its application to patient care. The last aspect will involve administering the end-of-course survey to students to analyze how the course content addressed their needs and areas that may require improvement before actual implementation. Using the individual scores on the six areas, the survey will indicate areas that may require polishing before the actual implementation. The attached student feedback questionnaire will be used to gather information about the instructor’s presentation of the course and the relevance of the module.

Refining and Improving Procedures

The feedback results from the students, academic nurse educators, and clinical instructors will be analyzed to determine changes before the actual implementation of the course. The curriculum development team will hold a meeting to discuss the feedback from each team and gauge evidence to determine the need for any changes.To improve the performance, strategies adding more learning resources to the course will be included. More research on the feedback will follow to determine whether the observed results were a result of faulty content or other causes like ineffective teaching strategies. The feedback will also be analyzed for similarity to best determine areas that may require permanent changes and those that could benefit from slight modifications. The mean score from each of the six end-of-course survey items will be analyzed. A value below 3 for any of the items will lead to a further assessment. For example, a value below 3 for the utilization of learning resources will lead to re-evaluation of the course materials and addition of more textbooks or journal articles into the course.

Faculty Training Plan

Faculty training and development is an important component of higher learning across all institutions. These individuals require training on the new technologies available to teach students including education on the current trends that affect the education sector. One of the advantages of training is the equipment of instructors with new teaching methods that promote understanding of content. The faculty can maintain consistent student experiences leading to improved organizational performance. The faculty training plan for the implementation of the EOL care module aims at achieving a smooth transition into the implementation of the EOL care module. The training will consist of several steps as described below.

Step 1. The initial step to faculty training will involve the formation of a training committee. The committee will function to oversee the overall training activity including making changes to the initial plan depending on the observed progress. The committee will meet to discuss the areas of training, training materials, and financial support required during training. A final training program will be submitted to the administration for review and stakeholders informed of their roles during the training program. The committee will also communicate regularly to the curriculum implementation team concerning progress and required resources.

Step 2. The second step will involve assembling training resources and communicating training sessions to the faculty members. The training committee will ensure resources like halls and display materials are available. Using emails and internal memos, the academic nurse educators will be informed about the training dates. The nursing students will also be notified about the new module and the expectations upon completion of the exercise.

Step 3. This section will involve the introduction of the module to the nurse educators and students. The training committee will be tasked with providing soft copies of the EOL care module to the nurse educators before the first training meeting. The instructors will go through the module content and assessments to familiarize themselves with what will be required during the actual implementation. The students will be given the course outline and description of key parts to promote awareness about the new curriculum.

Step 4. The first meeting with the academic nurse educators will take place at this point. The training committee will introduce the new learning strategies to the nurse educators with a focus on the utilization of the online learning environment and learning resources like journals available through the online platform. A presentation will follow to discuss the course objectives, required resources, and assessments that will be given to the students. The ANEs will be required to read assignments that will be presented to students to increase their knowledge about the subject area.

Step 5. The second meeting with the preceptors will focus on the utilization of the online learning environment using the LMS. The information technology team will actively train the preceptors on how to post discussion forums to students, sharing of content, and evaluation of student’s learning. This section will also focus on the utilization of videos to educate students and demonstrating various aspects of security-relevant to the course.

Step 6. This step will involve assessing the understanding of the course by the preceptors and any changes that may be required. To assess the preceptors’ understanding, a question-and-answer session will be held focusing on the course content and the utilization of technologies to improve student learning. The Teach-back method will be the most appropriate to assess the understanding of the new learning strategies like simulations and the utilization of the online learning environment. Reflection and feedback delivery will guide the training committee to understand areas that will require more changes. A survey provided at the end of the training period will function to identify areas that might require changes or more stress to ensure all preceptors are adequately prepared.

Technical Problems to Implementation

While it may sound obvious, technical problems are one of the main hindrances to online education and training. Technical challenges may cause difficulties with accessing information, retrieval of data when required, and even loss of important information. During the implementation of the EOL care module, technical problems that may be observed may include operating system incompatibility issues, regular updates, internet connection loss, and data security or issues.

Learning System Incompatibilities

The information technology team will be tasked with installing a learning management system (LMS) that will support online learning. Problems with the LMS system may arise especially if different computer systems are used during installation. Students may also need to access their online information using smartphones and tablets. Incompatibility issues especially with the use of different browsers and computers may cause problems with learning. To solve this issue, the IT department will conduct a thorough assessment of the installed LMS, inform students where it can be used and alternative mechanisms to access their information when incompatibility issues are observed.

Regularly Scheduled Updates

Computer system updates are important because they help in addressing discovered security holes and fixing or removing bugs. The updates help protect data and keep information secure from hackers. While these updates offer a lot of benefits, they are observed to disrupt normal access to websites and stored data. Students might find it difficult to access information during updates leading to delays and time wastage (Maurer, 2017). To help solve this challenge, the IT department will be advised to inform instructors and students of scheduled updates so that learning can take place early. Additionally, doing the updates during the weekends or odd hours will ensure that normal learning is not disrupted.

Internet Connection Issues

There are several issues with connectivity that students encounter while utilizing the online learning environment. These issues include dropped internet connection, poor audio or video quality, inability to access materials, and slow internet connection (Maurer, 2017). Depending on the strength of internet connection available in the institution, some of these challenges may be observed during the implementation of the EOL care course. To address this challenge, the IT department will regularly check for connections and use trusted vendors to provide reliable internet supply to the institution. Additionally, the online classes will be organized to avoid overlapping that is observed to promote slow connections due to multiple internet usage or access of the same website by multiple users.

Data Security Issues

There are various cybersecurity threats available today as technology evolves. Security issues may exist because of computer viruses that alter access to information and even deleting important data. Spy threats is also another program that can be used to install new programs into the computer leading to sharing of information (Maurer, 2017). Hackers and predators are other sources of security issues that can get into the system, steal information, or even change data formats. All these security challenges may arise during online learning. To address this challenge, the IT department will be asked to regularly update the LMS to clear bugs and unwanted programs. Secondly, the IT department should ensure all data is safely backed up so that data is not lost even during devastating attacks. If at all these measures fail, the ANE will revert back to the traditional method of teaching to allow the IT department to correct security issues. The ANE will print copies of the lecture, distribute the material to students, and continue with the teaching of the day.

Proposal Evaluation Planning Phase

Course Performance Metrics

Performance metrics always correlate with the key performance indicators and are used to assess the learner’s performance. These metrics are dependent on the time spent and inform the instructor of the student’s progress, learner competency, and instructor effectiveness. To determine the course performance metrics for the EOL care module, the first step involves conducting a meeting with the academic nurse educators. The meeting analyzed the learning resources, time allocated for the course, and relevance to nursing practice to determine performance metrics. The curriculum implementation team also actively participated in the meetings to ensure chosen metrics were evidence-based and met the required standards.

The identification of key performance metrics began by listing all the appropriate methods of assessing the effectiveness of the course. The key stakeholders voted on the evidence-based key performance indicators and benchmarks which would most accurately depict module appropriateness and relevance to nursing practice. Basing their argument on the guidance of the National League for Nursing (NLN) (2016), the first performance metric chosen involved the student pass rates upon completion of the course. It was agreed that a benchmark of 75% will be used to assess the individual performance of all students whereby those scoring above 75% will pass the course. Failure to attain this mark will indicate that the student did not meet the course objectives promoting re-sitting the exam or repeating the course. The inclusion of more teaching strategies will also serve to increase the student’s understanding of the course.

The second performance metric chosen was the course completion rates. It was agreed that more than 75% of the students must successfully complete the course to indicate engagement of learners (NLN, 2016). The stakeholders also agreed to assess the circumstances leading to the dropping of the course to determine areas that might require revision. Performance on licensure examination is another crucial metric that can be used to assess the student’s performance upon completion of the program (NLN, 2016). The NECLEX-RN standard is used as an outcome measure for the AND and BSN academic programs and the pass rates are dependent on the State accreditation. The results are linked to the portion of students who complete the program These evidence-based metrics were chosen because each measure would be indicative of the new module’s appropriateness, adequacy of learning resources, effectiveness, and relevance to nursing practice and learner success (NLN, 2016). The instructors also agreed that other courses utilized the same performance metrics and they had proven to be effective in determining the success of learning.

End-of-Course Survey Procedures

Course evaluation surveys cover various aspects of the course including the structure, course materials, teaching methods, and overall satisfaction with how the course was presented. This approach was used during the evaluation of the EOL care course to determine the student’s response that could inform any future changes. To determine the appropriate method of administering the survey, the curriculum committee held a meeting. All the stakeholders agreed that it was best to use closed-ended questions to directly measure the attitudes of students towards the course. An online search was conducted where the ‘Likert Scale’ was chosen to guide the construction of the survey. This item was used because of its ease of administration. The meeting also focused on the assessment metrics to be included in the survey. The survey included statements focusing on instructor performance, learning materials/resources, learning management system/technology, assessments and assignments, social learning/peer collaboration, and overall satisfaction with the course. The development of the statements was done through sharing and discussion to ensure each item could be correctly interpreted by the students.

Survey Question Analysis

Please Refer to Appendix D: End-of-Course Survey

Instructor Performance

The end-of-course survey will assess students on the performance of the instructors regarding the aspects of preparation, effectiveness, and organization. The survey item measuring this concept states that “The nurse educator was well-prepared for the course module.” The survey will yield information on whether the students agree or disagree with the way instructors presented themselves during learning. This information will help academic nurse educators to better their practice by reflecting on their teaching strategies and interaction with students.

Learning Materials/Resources

The survey will focus on the learning materials because they will be used to provide information to students about EOL care. The survey item measuring this concept states that “Learning resources were available, easy to use, and relevant to the subject matter.” The students will evaluate the materials based on their effectiveness to deliver content and relevance to the course. The learner would help inform the instructors if the materials provided additional information about EOL care and any changes that might be required. This area is crucial because baccalaureate students require additional knowledge and skills that can be obtained through the utilization of diverse learning methods.

Learning Management System/Technology Usability and Usefulness

The EOL care course will involve the utilization of online learning as one of the active learning strategies. This aspect will be measured by the survey question “Learning resources were available, easy to use, and relevant to the subject matter” and the open ended question at the end of the survey. The survey will focus on analyzing the usability of the learning management system, ease of information access and retrieval, and the usefulness of the system to the course. This information will determine the effectiveness of the online classrooms and the likelihood of students prefer the approach in subsequent courses.

Assessments and Assignments

The survey item measuring this concept states that “The assignments and assessments were reflective of the course module.” The survey will focus on aspects of the assessments including the difficulty of the curriculum, effectiveness of the learning activities, and appropriateness of the summative and objective assessments. The feedback will assess the delivery of superior knowledge to students through meaningful content creation.

Social Learning/Peer Collaboration.

This area will be used to determine the effectiveness of the course to engage students in collaborative learning. The survey item measuring this concept states that “The module encouraged collaboration and critical thinking.” This item will demonstrate the usefulness of the course in promoting interaction between learners and preceptors. It is important to assess this aspect because multidisciplinary patient care is highly encouraged today.

Overall Satisfaction with the Course.

The survey item measuring this concept states that “The course module met my expectations.” This aspect will assess if the student’s expected needs were met including the relevance of the course objectives. The learners will provide insight into the usefulness of the content, active learning strategies, and utilization of technology to improve their EOL care skills. The student’s perspective of the course is important because they are the consumers of the program and their satisfaction is crucial to organizational performance.

Formative Evaluation Plan

The ongoing review of the curriculum is critical to the success of any newly developed nursing course module. Formative evaluations are performed to improve the overall quality of a new curriculum that also leads to the improvement of learning experiences in an institution. The systematic process of the evaluation plan for this course will involve three stages; the pre-implementation phase, the implementation phase, and the post-implementation phase.

The first part will involve the evaluation of the pilot study including the three assessments. The ANEs will assess the student’s performance for the formative assessment and evaluate results to determine areas that may require improvement. The pilot data will guide the ANEs in the addition of learning materials, change of learning strategies, and refinement of the three assessments. The second part will involve implementation analysis. This aspect will include evaluation of barriers, implementation strategies, and student learning. Informal methods of data collection will be used at this stage including asking students during live teaching what could be done better or teaching strategies that can help improve their understanding of the course. Interventions like giving more case studies and including more discussions will serve to improve the teaching of the course.

The last part of the plan will involve the evaluation of the end-of-course survey results and recommendation of the final changes to the curriculum committee for approval. Emphasis will be put on the teaching and learning strategies used during the course and the student’s response towards the new course module. The student’s feedback will guide the team in making changes including the addition of learning materials, re-evaluation of the LMS technology use, and further education of ANEs to effectively deliver the course. Continued collection of data for one year will provide accurate statistics on the areas for improvement.

Conclusion

Nursing practice today is confronted by various challenges that need providers to stay up to date with medical knowledge and technology advancements. Nursing education is among the sectors observed to be the solution to the demands of patients through the preparation of highly competent practitioners. Advances in academia, degree requirements, and healthcare have mandated nurses to exhibit mastery of core knowledge, skills, and attitudes to demonstrate competency as a baccalaureate-prepared nurse. More specifically, nursing students should be adequately prepared to care for dying patients due to the increased burden of chronic diseases and the aging population in society.

Rationale and Purpose of Proposal

The demand for nursing expertise in end-of-life care is growing as more people are living with chronic-life-limiting illnesses. Several advances have been made in nursing education to incorporate curricula that could prepare students to deal with chronically ill and dying patients (Griffiths, 2019). The challenge observed is the lack of a curriculum that can prepare students to critically think while caring for dying patients. This means that students are inadequately prepared to care for dying patients leading to poor quality end-of-life care. The purpose of this proposal is to recommend revision of the current nursing curriculum in Western University to incorporate the end-of-life care course that will adequately address identified gaps. The rationale for implementing this course is that it will equip students with knowledge on the physical, emotional, and spiritual needs of dying patients. Utilizing active learning strategies like simulation-based learning, students will be able to experience care for dying patients before providing actual care in the hospital. Most importantly, the course will encourage self-determination among students and aid in decision making during times surround the patient’s death.

Filling the Curriculum Gap

Providing learners with an engaging, challenging superlative learning experience, that supports their growth as nurses is the goal of any nursing program. The curriculum gap observed in Western University is inadequate preparation of students with skills, knowledge, and expertise to effectively manage dying patients. The complex patient care module in the current nursing curriculum fails to address key aspects of EOL care like effective communication, patient and family-centered care, and support for the healthcare provider (Costa et al., 2016). Based on the preliminary assessment, this gap exists because there is a lack of active learning strategies utilization in the current nursing curriculum. To fill this gap, the constructivist learning theory will be utilized whereby active learning strategies will be incorporated in the new EOL care module. The online learning environment will also be introduced to the curriculum to ensure students have a variety of ways to access learning materials and to improve their EOL care skills.

Importance of Implementing the Proposal

Registered nurses are expected to autonomously promote the health and wellness of the community by practicing safe, effective, and efficient care. End-of-life care is among the areas that receive minimal attention in healthcare but is of utmost significance to patients and families (Costa et al., 2016). The introduction of the EOL care course acts to satisfy the needs of a dying patient by ensuring the student and qualified nurse prioritize care including care for the family. This course will allow the nurse to understand the pain families go through when they lose their loved ones and the special support required (Ferrell et al., 2016). The course will allow nursing students to be adequately prepared to care for dying patients rather than being shocked at the events surround the patient’s death in their clinical areas. Additionally, the introduction of the course will ensure students acquire effective communication skills and improved attitudes towards EOL care.

New Insights, Creative Approaches, and Diverse Learning Styles

New insight into the arena of nursing education reveals that both teaching and learning are arts as well as sciences. These processes are intertwined because as students learn new ways of teaching, teachers learn new styles of delivering content to students. During the implementation of the EOL care module, active learning styles were proposed to guide the proposal. Utilizing insight from the constructivist learning theory, it was evident that active learning strategies like simulation-based learning, group discussions, and the utilization of the online environment promote constructivist learning. The proposed course will incorporate these strategies to ensure students understand EOL care and the components that make it successful to care for dying patients. To address the diverse learning styles of students, the course will utilize the lecture method to ensure the visual and aural learners take notes and ask questions. Invoking group discussions will serve to engage the students while promoting visual and aural learning. The course will also promote kinesthetic learning through the use of simulation-based exercises. The inclusion of textbooks and journal articles will ensure that those students who prefer reading/writing get an opportunity to enjoy the course.

Alignment and Contribution to Nursing Education

Nursing education focuses on preparing students to care for the diverse needs of patients. The proposed course addresses a challenge that is observed in many institutions and how it can be solved through educational approaches. The new module provides learners with experiential learning that is relevant, evidence-based, and meaningful to their practice. The module utilizes diverse learning strategies like online learning, simulation-based learning, and group discussions that are significant approaches to nursing education. The course aligns with nursing education through the use of assessments, evaluation of student performance using acceptable key performance indicators, and the administration of the end-of-course survey to obtain feedback (NLN, 2016) The module contributes to nursing education because it deals with curriculum development which is a scholarly and creative process in nursing education. Using an evidence-based approach, the course provides an opportunity to students and nurses to improve the quality of care provided to patients through nursing education. The course provides students with a safe and judgment free environment to develop their critical thinking and decision-making skills that could better their career as they transform into the qualified nursing role.

Executive Summary

Nurses can make a major contribution in easing the transition from aggressive treatment to end-of-life care. To do so, the nurses must be prepared to make professional decisions regarding the type of care required and how to promote a peaceful death. Adequate preparation during nursing education and training acts as the key to the provision of quality end-of-life (EOL) care to patients. A curriculum gap identified in the institution prompted the implementation of an end-of-life care module into the nursing curriculum. The general underpinning of this curriculum proposal was the ADDIE model of instructional development that has five phases including analysis, design, development, implementation, and evaluation.

The analysis phase of the model involved the assessment of the learners’ needs and identification of the curriculum gap that was filled through the implementation of the EOL care module. Key stakeholders that contributed to the success of this phase included the nursing faculty, executive management, and academic partners.

The proposal design phase was utilized to determine the important aspects of the EOL care module and the goals for implementing the new approach. Collaborative approaches with the key stakeholders led to the successful establishment of the course objectives, learning resources, and instructional strategies.

The curriculum development phase provided an opportunity to utilize both independent and collaborative efforts to develop the course. The completion of this phase ensured that a course content outline, learning materials, student-centered learning outcomes, course policies, and course assessments to gauge the students’ understanding were strategically designed.

The Proposal implementation phase involved pilot testing to assess the workability of the new curriculum and the making of necessary changes to the module. Resources for the implementation of the module included human resources like the academic nurse educators, technology resources like the learning management system, and financial resources to support the implementation process.

The evaluation phase aimed at evaluating the effectiveness of the curriculum by analyzing successes and areas of improvement using the key performance indicators, benchmarkings, and student surveys. This phase provided an opportunity to assess the progress of the new curriculum and changes that might be made in the future. Analysis of the course performance metrics and administration of the student response survey was done.

References

Costa, Á. P., Poles, K., & Silva, A. E. (2016). Palliative care training: Experience of medical and nursing students. Interface-Comunicação, Saúde, Educação, 20, 1041-1052. https://doi.org/10.1590/1807-57622015.0774

Ferrell, B., Malloy, P., Mazanec, P., & Virani, R. (2016). CARES: AACN’s new competencies and recommendations for educating undergraduate nursing students to improve palliative care. Journal of Professional Nursing, 32(5), 327-333. https://www.sciencedirect.com/science/article/pii/S8755722316300850

Griffiths, I. (2019). What are the challenges for nurses when providing end-of-life care in intensive care units?. British Journal of Nursing, 28(16), 1047-1052. https://doi.org/10.12968/bjon.2019.28.16.1047

Maurer, H. (2017). Problems and solutions for using computer (networks) for education. Journal of Research in Innovative Teaching & Learning, 10(1), 63-78. https:///doi/10.1108/JRIT-08-2016-0002

National League for Nursing. (2016) Commission for nursing education accreditation: Accreditation standards for nursing education programs.

http://www.nln.org/docs/default-source/accreditation-services/cnea-standards-final-february-201613f2bf5c78366c709642ff00005f0421.pdf?sfvrsn=12

Table 3. Task and Timeline Table

Task to be Completed	Accomplished Date	Responsible Stakeholders
Scheduled meeting with the curriculum design team and other stakeholders to discuss implementation procedures.	28^th September 2021	Nurse educators Information technology team Nursing students MSN student
Discussion of changes and required resources for implementation.	28^th September 2021	Administration Curriculum design committee MSN student
Communication of the designed course through email and preparation of faculty members for training.	28^th September 2021	Curriculum design coordinator MSN student
Training of faculty members, students, and clinical nurse educators.	28^th September 2021	Academic nurse educators Clinical nurse educators Nursing students Information technology team Other external stakeholders
Obtain feedback from faculty regarding training and making necessary changes based on pilot testing results.	28^th September 2021	Nurse educators Students Information technology team MSN student
Actual implementation of the EOL care course.	28^th September 2021	Academic nurse educators Administration Nursing students Information technology team Clinical nurse educators
End of course survey and communication of feedback	28^th September 2021	Nurse educators Nursing students MSN student

Appendix D

End-of-Course Survey

Instructions: The following statements describe the student’s experience throughout the EOL care course. The statements are a reflection of the following areas experienced throughout the course: instructor performance, learning materials, learning process, assessments and assignments, collaborative practices and overall satisfaction with the course module. Please be honest in your survey by ticking against the most appropriate finding.

Survey Question	Strongly Disagree 1	Disagree 2	Average 3	Agree 4	Strongly Agree 5
1. The nurse educator was well-prepared to teach the course.
2. Learning activities were organized and well-facilitated.
3. Concepts and techniques were effectively presented by the nurse educator.
4. Learning resources were available, easy to use and relevant to the subject matter.
5. The learning process followed the course syllabus.
6. The module encouraged collaboration and critical thinking.
7. The assignments and assessments were reflective of the course.
8. The instructor inspired interest in the subject matter of this course.
9. The course improved the student’s ability to think critically.
10. Overall, the course met my expectations.

Please write briefly about your experience in during the utilization of the online learning environment.

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