Digital advance care planning education in nursing home placements: a qualitative descriptive study of nursing students’ experiences

Abstract Background Advance care planning (ACP) is a core component of high-quality palliative and end-of-life care, particularly in nursing homes where residents commonly experience frailty, multimorbidity and cognitive impairment. Although digital ACP education has shown promise for qualified staff, limited qualitative evidence has examined how undergraduate nursing students experience such learning during clinical placement. This study explored first-year nursing students’ experiences of using an online e-resource during nursing home placements exploring its acceptability, perceived influence on knowledge and confidence, and application to practice. Methods A qualitative descriptive study was undertaken within a UK School of Nursing and Midwifery. All eligible first-year undergraduate nursing students undertaking nursing home placements between January and March 2024 received access to a care-home-specific ACP e-resource. Sixteen students participated in semi-structured online interviews. Data were analysed using reflexive thematic analysis, informed by Social Cognitive Theory, particularly self-efficacy. Results Three interrelated themes were identified: Building Confidence, Putting Learning into Practice, and Spreading the Learning. Students described the resource as accessible, relevant to the nursing home context, and appropriately pitched to their stage of learning. It appeared to support greater perceived readiness to recognise and engage with ACP-related issues in practice, including discussion of deterioration, future care and end-of-life planning. Students also valued acknowledgement of the emotional impact of care, particularly the inclusion of self-care content. Although participants identified limitations of asynchronous learning and expressed a preference for greater rehearsal and interactivity, many also described sharing the resource with staff, peers and others in practice settings. Conclusions A digital, care-home-specific e-resource may support undergraduate nursing students’ preparedness for palliative and end-of-life communication during nursing home placements. Embedding context-specific digital ACP education within preregistration curricula may strengthen early preparedness, particularly when supplemented by opportunities for reflection, rehearsal and discussion.