Student thesis: Doctoral ThesisDoctor of Philosophy


The End-of-Life Care Strategy (DH 2008), Quality Standards for End-of-Life Care for Adults (NICE 2013) and One Chance to Get it Right (LACDP 2014), expect nurses to provide compassionate care with sensitive communication to the dying and their relatives. However, More Care Less Pathway reported examples of less than optimum care and communication (DH 2013). There has been a call for basic knowledge of end-of-life care to be in pre-registration nurses’ programmes, but there are currently no curricula guidelines (DH 2008, 2013). Therefore, this study aimed to explore undergraduate pre-registration nurses’ perceptions of how learning end-of-life-care could be enhanced in the Higher Education Institute (HEI) and Clinical Learning Environments (CLE).

A review into the effect of pre-registration nurses’ education on end-of-life-care revealed eleven quasi-experimental studies. These suggest that following education programmes, knowledge and attitude towards end-of-life-care appeared to improve. However, only one study occurred in England. A meta-ethnography into pre-registration nurses’ experiences of providing end-of-life-care revealed its emotional impact, including grief, anxiety and fear. This was influenced by ward culture, type of death, performing last offices, difficult communication with patients and relatives and support from friends and nurses. However, these studies did not explore pre-registration nurses’ perceptions of factors that enhance how they learn to provide end-of-life-care.

A qualitative investigation was undertaken using focus group methodology. Twelve final year BSc Nursing (Adult) pre-registration students participated in three focus group interviews. Transcripts were analysed following techniques recommended by Strauss and Corbin (1998), including constant comparison, open, axial, selective and process coding. Five key elements that enhanced pre-registration nurses learning were elucidated: translation of knowledge between the HEI, CLE and P-RNs; role modelling; P-RNs motivation to learn, being able to manage the emotional labour of EOLC and the creation of a safe learning environment. It is recommended that future research should be directed towards a longitudinal study following pre-registration nurses learning during the programme, at six months and 12 months after qualification to reveal how knowledge is translated into end-of-life-care.
Date of Award2016
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorJaqualyn Moore (Supervisor) & Jo Armes (Supervisor)

Cite this