Preparing Undergraduate Nursing Students for Palliative Nursing: Conceptual Framework, Core Competencies, and Integrated Teaching-Learning Approaches

Abstract

Palliative care is a key component of health systems in ageing societies, amid the increasing burden of chronic and life-limiting illnesses. In Thailand, national policies, professional guidelines and service systems for palliative care have been developed in concrete ways; however, gaps remain in the knowledge, skills and attitudes of nursing students and novice nurses, particularly in communication, symptom management and facing death. This article aims to present a conceptual framework and core palliative care competencies for undergraduate nursing students prior to clinical practice, together with integrated teaching–learning approaches that are aligned with the Thai health-care context. The analysis synthesises international competency frameworks with Thai research and documents on nursing education, policy and faculty practice experiences. The synthesis leads to a three-domain competency framework: (1) knowledge of principles, disease burden, symptom assessment and ethics; (2) practical skills in assessment, communication, basic care and interprofessional teamwork; and (3) attitudes and professional values, such as acceptance of death, respect for patients’ dignity and beliefs, and reflective practice. These domains are then organised into the PREP framework—Principles & Policy, Readiness & Reflective Attitude, Essential Skills and Partnership & Professionalism—as a prototype for designing pre-clinical preparation programmes. The article concludes with policy, educational and research implications for using this framework to develop curricula, courses and teaching innovations, and to generate scholarly work by nurse educators, viewing the preparation of nursing students for palliative care as an investment in “the heart of the profession” alongside improving the quality of life of patients and families at the end of life.