A new study from BC Cancer researchers explores how to better support oncology nurses in engaging patients and families in advance care planning (ACP). ACP is a process that encourages patients to reflect on their values and wishes for future health and personal care, and to share those preferences with trusted individuals and their healthcare team. Having these conversations early helps ensure that the care they receive aligns with what matters most to them.
Through a qualitative study involving individual interviews with oncology nurses at all six of BC Cancer’s regional centres, the research findings highlighted several factors that can affect nurses’ abilities to engage in ACP, including limited training, systemic barriers and unclear expectations.
The study was inspired by an observation made by Heather Kilgour, clinical nurse specialist, during her time as a direct-care nurse at BC Cancer – Vancouver and set in motion with guidance from Leah Lambert, senior scientist and nursing research theme lead with the BC Cancer Research Institute.
“Part of our practice as nurses in the ambulatory care unit is to introduce advance care planning to each patient,” says Kilgour. “However, I didn't feel like I had the knowledge, resources or supports to do that in the best way as ACP is not something we learn a lot about in school and I didn’t learn a lot about it when I first started at BC Cancer. I felt like there was an opportunity to better support nurses and improve patient care.”
The study found that while nurses often recognize the importance of ACP, they need clearer role definitions, enhanced education and stronger organizational support to confidently lead these conversations. The findings underscore the value of structured workflows, interdisciplinary collaboration and leadership support in making ACP a consistent component of oncology care.
Building on these findings, Kilgour led a province-wide initiative to integrate ACP into nursing practice across BC Cancer’s six regional centres. Working with professional practice leaders, educators and patient partners, the team developed new educational resources, clinical workflows and patient-facing materials to make ACP a routine part of care.
This initiative was supported by the Michael Smith Health Research BC’s Reach Program, which promotes knowledge translation by helping researchers extend the research of their work through tools and resources. The BC Nurses’ Union also supported this knowledge translation work.
The team developed essential resources to help direct-care oncology nurses navigate conversations. New resources for health professionals include an updated ACP orientation, an ACP video and nursing scripts. Patient-facing materials include ACP handouts. The BC Cancer Foundation supported the production of these resources.
“Nurses asked for guidance, such as scripts, patient materials, education sessions, so we built those resources,” added Kilgour. “Having these supports in place helps nurses feel confident, and it ensures patients’ goals and priorities are truly heard.”
Early evaluations show that nurses now feel more confident and equipped to initiate ACP discussions, and patients are experiencing more opportunities to share their values and preferences. This work demonstrates how nursing research can directly shape clinical practice, helping to ensure care at BC Cancer is guided not only by evidence but also by the voices of direct-care nurses, patients and families.