Acceptance and Feasibility of Delivering an Evidence Based Digital Intervention for Palliative Care Education: A Mixed Method Study

Abstract

Background: There is a growing need for palliative care as a result of a rise in the number of people diagnosed with non-communicable diseases. Palliative care is based on multidisciplinary teamwork, and the provision of care is significantly aided by the work of nurses. Therefore, education is an essential element in elevating the standard of palliative care in general. The subject of palliative care has not yet been introduced into nursing curricula in Saudi Arabia. Undergraduate students' understanding of palliative care may be improved via the use of digital learning, which is not only an effective method of education but also a persuasive one. Objectives: The primary aim of this study was to evaluate the feasibility of delivering palliative care education to nursing students via digital learning in Saudi Arabia. Primary Objectives: 1: To present initial findings on the feasibility and acceptance of implementing a digital palliative care educational intervention for undergraduate nursing students in Saudi Arabia, specifically to assess engagement, attrition, recruitment, and adherence to the intervention. 2: To evaluate participants’ perceptions and satisfaction with the intervention. Secondary Objectives: to determine whether specific outcomes change following the intervention, particularly to assess the impact on participants' confidence and knowledge levels before and after the intervention.

Methods: This study employed a convergent parallel mixed-methods research (MMR) design using a single-group feasibility approach. Participants were undergraduate nursing students from Shaqra University, Saudi Arabia. The palliative care digital intervention contains 4 modules, and the program duration was 4 weeks. The study's primary outcomes focused on feasibility indicators, including recruitment rate, attrition rate, intervention adherence, outcome measure feasibility, and overall program experience. The secondary outcomes explored changes in palliative care-related knowledge and confidence levels by using the palliative care nursing quiz and the palliative care self-efficacy scale. Quantitative data on primary and secondary outcomes were collected before and after the intervention. Qualitative data were gathered through semi-structured interviews to explore participants' experiences and perceptions of the intervention. Key findings: A total of 52 nursing students were recruited. The conclusions from quantitative data demonstrated the feasibility of the major outcomes. Participants showed improvements in secondary outcome measures following the intervention: Knowledge (M=8, SD 4.30) and Confidence (M=24, SD 7.26). Thematic analysis of interviews from 13 participants identified four key themes (Students’ perceptions of intervention usability, Usefulness of the intervention, Levels of engagement and Suggestions for future improvement). The data were assessed and compared to predefined feasibility and success criteria following quantitative and qualitative data analysis. The study procedures, data collection methods, and feasibility indicators—including recruitment rate, attrition rate, intervention adherence, and outcome measure feasibility—were feasible and effective. Implications This is the first research in Saudi Arabia looking into the feasibility and acceptability of a digital palliative care curriculum for undergraduate nursing students. This thesis tackles the need for increased palliative care education in Saudi Arabia by creating a theory-based online education module tailored to the needs of the target participants. This educational intervention is an important step toward addressing a shortage of resources in Saudi palliative care education, as instructional opportunities on this issue are currently unavailable in educational institutions. The findings, based on quantitative and qualitative data, provide convincing evidence for the feasibility and applicability of digital palliative care teaching for enhancing undergraduate students' knowledge and confidence. This feasibility study revealed the potential of digital education in this sector and laid the groundwork for a large randomised controlled trial (RCT) through the use of an innovative approach. The findings suggest that the digital palliative care education intervention is feasible, practical, and well-received among undergraduate nursing students. This study highlights promising opportunities for future research, particularly a definitive trial to assess the program’s long-term effectiveness and impact within the Saudi Arabian context.