Digital Interventions for Palliative Care Education for Nursing Students: A Systematic Review

Abstract

Background/Objectives: Palliative care education is a core component of undergraduate nursing preparation; however, many nursing students report limited exposure and confidence in providing end-of-life care. Digital and web-based educational approaches have increasingly been adopted to address gaps in palliative care training and to provide flexible, scalable learning opportunities. This mixed-methods systematic review examined the use of digital and web-based approaches in palliative care education for pre-registration nursing students. The aim was to synthesize existing evidence on educational outcomes, confidence development, practice preparation, and acceptability to guide future design and implementation of technology-enhanced learning in this field. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. The search was conducted across Medline (Ovid), Embase, CINAHL, Scopus and PsycINFO in October 2025. Studies employing qualitative, quantitative, or mixed-methods designs were eligible if they evaluated fully digital or web-based palliative care educational interventions for nursing students. Screening, quality appraisal, and data extraction were undertaken independently by multiple reviewers. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Extracted data were synthesized narratively to integrate qualitative and quantitative findings. Results: The search yielded 1826 records; after removing duplicates and applying eligibility criteria, 12 studies were included in the final synthesis. Considerable heterogeneity in design and outcomes was observed. Most included studies reported improvements in students’ knowledge, self-efficacy, and reflective capacity, alongside high levels of acceptability. Conclusions: Digital and technology-enhanced learning appears feasible and acceptable for palliative care education; however, the current evidence base is limited by methodological heterogeneity, reliance on self-reported outcomes, and predominantly short-term evaluations. Further rigorous, large-scale studies with objective outcome measures are required to determine sustained educational and practice impact.