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Release: Feb. 26, 2002

UI nursing faculty to develop Web-based course on end-of-life issues

University of Iowa College of Nursing faculty have received a grant to develop a Web-based course on end-of-life care. The goal of the new course initially will be to educate nursing and other health professional students at the UI about issues surrounding care for older adults approaching death and for their families; it likely will be offered to practicing nurses and others in the future.

The three-year, $90,000 award comes from the John A. Hartford Foundation of New York and the American Association of Colleges of Nursing. Paula Mobily, Ph.D., associate professor of nursing at the UI, is principal investigator for the project. Mobily also serves as education coordinator for the Hartford Center for Geriatric Nursing Excellence, which is based at the UI College of Nursing.

"We have faculty with strong backgrounds in pain management and end-of-life care as well as ties with experts in palliative care throughout the country," Mobily said. "We plan to capitalize on these resources to carry out this project."

In addition to Mobily, UI nursing faculty involved in development of the course are Keela Herr, Ph.D., professor; Jo Eland, Ph.D., associate professor; Paula Forest, clinical assistant professor; Kristine Kwekkeboom, Ph.D., assistant professor; Meridean Maas, Ph.D., professor; Sheryl Miller, lecturer; and Deborah Schoenfelder, Ph.D., clinical associate professor. The project team also will ask faculty in other disciplines to contribute their ideas concerning course content.

Although health providers and the public have gained considerable awareness of end-of-life issues in recent years, reports and studies indicate older adults often don't receive adequate care at life's end. Mobily and her colleagues attribute this not to a lack of effective therapies but to the fact that many health professionals simply don't know the latest and best available practices. Management of pain and other symptoms, ethical and legal issues, and the needs of family care givers all play an important role in caring for dying elders, Mobily said. Other key elements of the course content include the application of research evidence to support bedside care decisions and consideration of the role of interdisciplinary teams in caring for dying elders and their families.

"Students have a lot of interest in this," Mobily said, noting that some nursing students have formed an end-of-life interest group, "but to this point there haven't been any formal courses available." This will be the college's first stand-alone course on end-of-life care. Currently, end-of-life issues are covered as units within a gerontological nursing course, an oncology elective and a gerontology practicum includes a highly sought-after hospice experience.

Mobily expects development of course content to take a year. After that, it will be offered to undergraduate and gerontology nurse practitioner students for credit. The course also will be available to students in related health fields.

"End-of-life care education is becoming an important initiative nationwide," Mobily said. "The unique character of our offering is that it's Web-based. This method for delivering the course content will make it accessible for many different types of learners." Web-specific educational strategies for the course will include the identification of links to information about topics covered in the class, on-line posting of required readings and case studies, bulletin board and chat room discussions on relevant subjects and topical discussions moderated by recognized experts in end-of-life care.

Mobily said the course will continue after the three-year funding period ends. She and her colleagues also plan to adapt it for practicing nurses and other health professionals. One group in particular that could benefit from Web-based instruction, Mobily said, is nurses who work in long-term care facilities, where staffing concerns and long distances limit the ability of nurses to attend off-site classes. The college also hopes to market the course statewide through the Iowa Association of Colleges of Nursing, and regionally to six universities affiliated with the Hartford Center for Geriatric Nursing Excellence. Project faculty will explore the possibility of national and international outreach as well, Mobily said.

The project is funded through the Geriatric Nursing Education Project, a collaborative effort by the American Association of Colleges of Nursing (AACN) and the Hartford Foundation. The AACN represents 556 member schools offering baccalaureate and higher degrees in nursing and sponsors numerous programs, including the End-of-Life Nursing Education Consortium. The John A. Hartford Foundation, established in 1929, promotes programs addressing health and aging issues and distributes about $20 million a year in grants. In 1997, New York University established the John A. Hartford Foundation Institute for Geriatric Nursing with funding from the foundation. The organization also has spearheaded efforts to improve patient care through its Best Practices initiatives.