Caring Beyond Words: Effectiveness of a Blended Communication Training Program on Nurses’ Competence in End-of-Life Care

Abstract

Background: Effective communication is essential in palliative and end-of-life (EOL) care; however, many nurses report inadequate preparation for sensitive conversations, leading to poor patient and family outcomes.

Methodology: A quasi-experimental pre-test/post-test study was conducted in two tertiary hospitals in New Delhi, India (January–September 2025). Sixty registered nurses participated in a 3-day training program incorporating lectures, role-play, and high-fidelity simulation. Competence was assessed using the End-of-Life Communication Competence Scale (Cronbach’s α = 0.88), OSCE checklists, and self-reported confidence. Quantitative data were analyzed using paired t-tests and repeated-measures ANOVA, while qualitative data were thematically analyzed.

Results: Competence scores improved significantly from baseline (54.2 ± 6.1) to post-training (72.8 ± 5.9, p < 0.001, Cohen’s d = 1.56) and remained high at one-month follow-up (70.3 ± 6.4, p < 0.001). OSCE scores (78.6 ± 7.2) confirmed skill acquisition.

Conclusion: Structured, blended training significantly enhances nurses’ communication competence in EOL care with sustained effects.

Keywords: Caring; Palliative Care; Communication; Nursing; End-of-Life Care