Educating nursing home staff on end of life conversations during COVID-19: A virtual train-the-trainer approach

Background: End of life conversations can be difficult for both family carers and nursing home staff and can result in 'missed conversations' regarding resident's disease progression and health status. During COVID-19, communication between family carers and nursing home staff has proven particularly difficult. Ensuring nursing home staff are educated in how to hold conversations on end of life (EoL) is essential. Aim: To educate nursing home staff to hold EoL conversations during a pandemic using the virtual learning environment CANVAS. Methods: Using a Train the Trainer approach an online training course was developed using Fleming's VARK model. This provided resources for an external facilitator to support nursing home staff in holding EoL conversations with family carers virtually. Using the Comfort Care Booklet, modules included strategies to support nursing home staff in communication, good practice and handling challenging situations. Training was provided for external facilitators across six countries who would then support nursing home staff virtually on holding conversations in a virtual environment. Training statistics and anonymised evaluation data were captured by the CANVAS platform. Results: Twelve facilitators from six countries completed online training (internal and external);Canada (n=1), Czech Republic (n=1), Netherlands (n=2), Republic of Ireland (n=1), United Kingdom (n=5). Training to date has been received well. In total 100% of participants found training to be beneficial. Preliminary feedback included 'Canvas was good and easy to navigate';'Training excellent and covered all aspects for the internal and external facilitator'. Conclusion: Supporting online education of nursing home staff is accessible and feasible to deliver at an international level. Preliminary data signals that even with social distancing restrictions, nursing home staff can still be supported to hold conversations with family carers virtually regarding resident's EoL needs.