{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T07:05:40Z","timestamp":1779519940033,"version":"3.53.1"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"crossref","award":["Grant number: JP 20K19088 and 23K09977"],"award-info":[{"award-number":["Grant number: JP 20K19088 and 23K09977"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliative Medicine Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Early-career nurses often encounter difficulties in symptom management and communication with patients and families in palliative care. Although simulation-based education improves clinical competence, most programs require in-person participation. Evidence regarding the feasibility and outcomes of fully online simulation with immediate feedback for palliative care training remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To examine the perceived outcomes and feasibility of a fully online simulation-based palliative care education program for early-career nurses in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Exploratory pre\u2013post, single-arm study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Subjects:<\/jats:title>\n                    <jats:p>The study was conducted in Japan and included 34 early-career nurses with 2\u20134 years of clinical experience who participated in a 90-minute online program delivered via Zoom.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>The program comprised briefing, simulation, group work, and debriefing sessions focusing on total pain and communication. Outcomes were assessed at baseline, immediately post-intervention, and 1 month after using the Palliative Care Difficulties Scale, Nurses\u2019 Difficulty with Cancer Care Scale, Palliative Care Self-reported Practices Scale, and measures of confidence and satisfaction. Open-ended responses were analyzed descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Scores improved significantly from baseline in Palliative Care Difficulties Scale scores for symptom alleviation (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.024,\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      = 0.41) and communication (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002,\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      = 0.57). Confidence in recognizing total pain (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.008,\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      = 0.63) and communication (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.011,\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      = 0.66) increased from baseline. Researcher-rated practice levels improved in 9 of 14 items, and mean satisfaction was 5.2\/6. Qualitative findings indicated that most participants applied their learning in clinical practice.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These findings suggest that the program may contribute to improvements in perceived difficulties and confidence, supporting its potential feasibility as an educational model.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26892820261441692","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T06:03:22Z","timestamp":1779343402000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Online Simulation in Palliative Care Education for Early-Career Nurses in Japan: A Pre\u2013Post Exploratory Evaluation of Perceived Outcomes and Feasibility"],"prefix":"10.1177","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4248-5890","authenticated-orcid":false,"given":"Anri","family":"Inumaru","sequence":"first","affiliation":[{"name":"Department of Nursing, Graduate School of Medicine, Mie University, Tsu, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4944-6903","authenticated-orcid":false,"given":"Tomoko","family":"Tamaki","sequence":"additional","affiliation":[{"name":"Department of Fundamental Nursing, Shiga University of Medical Science, Otsu, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayumi","family":"Tsujikawa","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Suzuka University of Medical Science, Suzuka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5183-6726","authenticated-orcid":false,"given":"Miwa","family":"Skaguchi","sequence":"additional","affiliation":[{"name":"Department of Nursing, Graduate School of Medicine, Mie University, Tsu, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0328-4557","authenticated-orcid":false,"given":"Yoshiko","family":"Takeda","sequence":"additional","affiliation":[{"name":"Center for Medical and Nursing Education, Mie University, Tsu, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6875-6275","authenticated-orcid":false,"given":"Jun","family":"Kako","sequence":"additional","affiliation":[{"name":"Department of Nursing, Graduate School of Medicine, Mie University, Tsu, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(18)30415-7"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2009.0289"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.2512\/jspm.9.158"},{"key":"e_1_3_6_6_2","unstructured":"Japan Association of Nursing Programs of Universities. Model core curriculum for nursing education (revised FY2024): Competencies. Japan Association of Nursing Programs of Universities: Tokyo Japan; 2024. Available from: https:\/\/www.janpu.or.jp\/core-curriculum\/ [Last accessed: February20 2026]."},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-020-05787-1"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13907"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1432"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.learninstruc.2023.101773"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecns.2025.101774"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.17016"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000038813"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2014.08.001"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.2196\/13681"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13187-022-02245-w"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecns.2025.101865"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecns.2025.101892"},{"key":"e_1_3_6_19_2","unstructured":"American Association of Colleges of Nursing (AACN). ELNEC-Cares and G-CARES: Primary palliative care competencies for undergraduate and graduate nursing students 2nd ed [Internet]. Washington DC: AACN 2022. Available from: https:\/\/www.aacnnursing.org\/Portals\/42\/ELNEC\/PDF\/ELNEC-Cares-and-G-CARES-2nd-Edition.pdf [Last accessed: February20 2026]."},{"key":"e_1_3_6_20_2","volume-title":"Experiential Learning: Experience as the Source of Learning and Development","author":"Kolb DA","year":"2014","unstructured":"Kolb DA. Experiential Learning: Experience as the Source of Learning and Development. 2nd ed. FT Press: Pearson Upper Saddle River, New Jersey (US); 2014.","edition":"2"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295X.84.2.191"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecns.2021.08.018"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.3.361"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/10966218251371124"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.51970"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.2512\/jspm.8.240"},{"key":"e_1_3_6_27_2","unstructured":"Center for Medical Simulation. Debriefing assessment for simulation in healthcare (DASH): Student version. 2011. Available from: http:\/\/www.harvardmedsim.org [Last accessed: February20 2026]."},{"key":"e_1_3_6_28_2","volume-title":"Content Analysis in Communication Research","author":"Berelson B","year":"1952","unstructured":"Berelson B. Content Analysis in Communication Research. Free Press: New York; 1952."},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.3758\/bf03193146"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2925"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369-7625.2004.00266.x"},{"key":"e_1_3_6_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2008.04729.x"},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2021.02.033"},{"key":"e_1_3_6_35_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10010046"},{"key":"e_1_3_6_36_2","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.2104"},{"key":"e_1_3_6_37_2","doi-asserted-by":"publisher","DOI":"10.2196\/58744"}],"container-title":["Palliative Medicine Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26892820261441692","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/26892820261441692","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26892820261441692","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T06:46:20Z","timestamp":1779518780000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/26892820261441692"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":36,"alternative-id":["10.1177\/26892820261441692"],"URL":"https:\/\/doi.org\/10.1177\/26892820261441692","relation":{},"ISSN":["2689-2820","2689-2820"],"issn-type":[{"value":"2689-2820","type":"print"},{"value":"2689-2820","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"article-number":"26892820261441692"}}