Bridging the Gap: The Impact of Interprofessional Simulation on End-of-Life Communication

Background and Purpose: Effective end-of-life (EOL) communication is a core yet challenging competency for health professionals. While Social Workers (SWs) and Physician Assistants (PAs) are vital to EOL discussions, students often report limited knowledge and low comfort levels with EOL care. Simulation-based education offers a safe environment for high-stakes EOL conversations, yet many existing simulations are single-discipline and lack interprofessional depth. This mixed methods study evaluates the impact of a joint SW and PA simulation by addressing three primary research questions:

1. Does participation in an interprofessional end of life simulation impact PA and SW student knowledge of EOL care and comfort with EOL communication?
2. How do PA and SW students perceive that participation in an interprofessional EOL simulation impacted their knowledge of EOL care and comfort with EOL communication with patients and families?

1. How do PA and SW students perceive that participation in an interprofessional EOL simulation impacted their knowledge of and comfort with an interdisciplinary approach to EOL care?

Methods: SW and PA students from two US institutions participated in a joint EOL simulation focused on a family meeting. Paired students assumed discipline-specific roles to communicate prognosis, provide emotional support, and discuss goals of care with standardized patients (SPs) portraying family members of a patient with brain death. The sessions included structured debriefing with interprofessional faculty and SPs. Using a convergent mixed-methods design, researchers analyzed pre- and post-simulation surveys featuring items from the Multidisciplinary End-of-Life Knowledge Scale (MELKS) and the Comfort with Communication in Palliative and End-of-Life Care (C-COPE) instrument. Qualitative data were gathered via open-ended survey questions and a semi-structured focus group, then analyzed thematically.

Results: Matched responses from 16 participants showed significant improvements in EOL knowledge (p = 0.002) and communication comfort (p = 0.014). Qualitative analysis identified three primary themes: 1) developing flexibility and humility in response to family emotions; 2) valuing multisource feedback from faculty, SPs, and peers; and 3) appreciating the complementary nature of PA and SW roles during EOL care.

Conclusions and Implications: This interprofessional simulation enhanced learners' perceived knowledge and comfort. Qualitative findings suggest the experience deepened students' understanding of family dynamics during emotionally charged EOL conversations and the value of collaborative feedback. These results indicate that interprofessional simulation is an impactful pedagogical method for fostering the skills necessary for collaborative EOL care. In conclusion, interprofessional simulation is a feasible and effective strategy for preparing health professions learners to navigate complex, collaborative end-of-life discussions with compassion and competence.