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Toolkit for Nurturing Excellence at End-of-Life Transition (TNEEL)

Funded by the Robert Wood Johnson Foundation; 1999-2003

TNEEL is an innovative, easy-to-access, teacher/learner-friendly package of electronic tools for palliative care education.

TNEEL includes topics such as:
  • comfort goals and preferences
  • assessment and management of pain and other symptoms
  • signs and symptoms of approaching death
  • decision-making at the end of life
  • communications and relationships supporting patient and family-centered care at the end-of-life transition
  • grief, loss, and bereavement
  • hope and well being
  • complementary comfort therapies
  • spiritual and psychosocial needs
  • impact of dying (epidemiology, economics, service delivery systems, and resource utilization at end of life)
  • cultural, ethical, legal and quality of life concerns at this life-stage
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TNEEL-NE Training Sessions Schedule

Diana J. Wilkie, PhD, RN, FAAN, Professor****, Principal Investigator
M. Kay M. Judge, RN, MNEd, EdD, Senior Fellow*
Marie-Annette Brown, PhD, ARNP, FAAN, Professor*
Sarah E. Shannon, PhD, RN, Associate Professor*
Stuart Farber, MD, Associate Clinical Professor**
Inge Corless, PhD, RN, FAAN, Professor***

University of Washington School of Nursing*
University of Washington School of Medicine**
Massachusetts General Hospital (MGH) Institute of Health Professions***
University of Illinois College of Nursing****

Led by Diana Wilkie, PhD, RN, FAAN, Professor and Harriet Werley Chair for Nursing Research at the University of Illinois College of Nursing, an interdisciplinary team from the University of Washington and the Institute of Health Professions at Massachusetts General Hospital developed TNEEL. A diverse group of consultants from across the USA also contributed expertise to the project.

TNEEL content is presented in six modules (comfort, connections, ethics, grief, well being, impact) and addresses the AACN's "Competencies Necessary for Nurses to Provide High-Quality Care to Patients and Families During the Transition at the End of Life." Core concepts are threaded throughout the TNEEL content, including individual and cultural diversity, life span, family-centered care, collaboration, interdisciplinary care, setting of care, system of care, values and attitudes. The content is organized as a teaching portfolio including:

  • student learning objectives
  • myths (misconceptions and assumptions)
  • definitions (verbal and image/sounds)
  • pre-assessment items (attitudes and belief questionnaires for self-reflection)
  • teaching materials (lecture outline; PowerPoint slides (1000 slides); speaker notes and tips for each slide; audio (184 clips), video (56 clips), graphical exemplars for the content; photos of patients, family, health team members; action videos and sounds to demonstrate effective and ineffective communication techniques, conflict resolution, collaboration between nurses and other team members; case studies; images and sounds to demonstrate anatomy, physiology, and pathophysiology concepts;
  • case studies (written, narrated, movie clips) for problem based learning; standardized patient scenarios
  • learning activities (critical thinking, study, discussion; symptom assessment scales for patients; equianalgesic charts; charts, graphs showing pharmacologic principles)
  • post-assessment items (sample exam questions; attitudes and belief questionnaires for self-reflection and evaluation)

TNEEL was distributed free of charge via CD-ROM to nurse educators in all BSN and AD academic programs of nursing and in 1,000 clinical settings, giving them ready access to end-of-life teaching/learning resources. For cost of shipping and handling, TNEEL will be made available to all other health care organizations. Contact us at tneel@uic.edu for prices, or you may order TNEEL online here. Investigators will offer hands-on training sessions to assist users to learn TNEEL features and options and to maximize the teaching capabilities related to end-of-life care.

Via the Internet in 2003, TNEEL will provide practicing nurses (RNs, LPNs) with a self-study course on end-of-life issues. At the conclusion of this project, nursing organizations and continuing nursing education providers will offer TNEEL as a current, evidence-based self-study course for the national and international nursing community.

Copyright © 2011, D.J. Wilkie, Last updated - May, 2011