Literature Review

Clinical Artificial Intelligence as a novice nurse: Leadership responsibilities for safe implementationNurse Leader; by Asiah Ruffin; 5/26Clinical artificial intelligence (AI) technologies are increasingly integrated into health care environments, influencing clinical workflows, documentation, decision-making, and patient communication. While AI is often introduced as a technical innovation, its implementation presents significant leadership responsibilities related to safety, workforce readiness, and organizational oversight. This commentary proposes an analogy that conceptualizes clinical AI systems as novice nurses—entities that require structured orientation, supervision, feedback, and ongoing development rather than autonomous trust. Using this analogy, the article examines risks associated with premature reliance on AI, including workflow disruption, performance variability over time, and limited user understanding of system capabilities and limitations. The commentary also outlines practical leadership considerations, including investing in workforce education, collaborating with human factors experts, establishing governance processes, and engaging in policy advocacy.

Palliative care or hospice? Flipping the classroom for 1st year pre-clinical medical students with interactive online contentAmerican Journal of Hospice & Palliative Care; by Maxwell Vergo, Charles Wang, Lawrence Myers; 5/26Although palliative care competencies appear on USMLE [United States Medical Licensing Examination] examinations, pre-clinical curricula devote minimal time to end-of-life education. We created a 30-minute interactive online module in Articulate 360™ for first year students covering palliative care definitions, eligibility criteria, and care settings. In-class time was restructured to small group case discussions distinguishing primary palliative care, specialty palliative care, and hospice. Correct responses on a palliative care examination question improved from 57% (2020-2021, virtual lecture) to 66%, 67%, and 80% in subsequent years with the flipped intervention. The pre-work engaged students in learning (79-89% agreement), enabled focus on advanced topics during class (73-77% agreement), and was described as interactive and helpful in teacher evaluations.

Pediatric home-based hospice and palliative care: A scoping reviewBMC Palliative Care; by Ellen Davis, Daniel H Grossoehme, Toluwalase Ajayi, Justin N Baker, Pamela S Hinds, Lisa Humphrey, Jill Ann Jarrell, Rachel Thienprayoon, Sarah Friebert; 5/26Pediatric palliative and/or hospice care is provided across a broad spectrum of settings, ranging from inpatient to outpatient to a child's home. Pediatric home-based hospice and/or palliative care teams offer a specialized, interdisciplinary approach to care, allowing children to stay in the home while offering comprehensive support. Common themes emerged [in this review] including studies analyzing models of care, characterizing the population, end-of-life decision making, clinical outcomes of home-based hospice and/or palliative care, costs and economic impact, family experiences, quality domains, specific treatment modalities, and the use of telehealth. Overall, the available literature supported home-based hospice and/or palliative care as an effective model of care, reducing the burden on families, improving quality of life, and allowing families to stay in their preferred setting for care without sacrificing clinical outcomes.

Referral and utilization patterns for home-based palliative care services among older adults BMC Palliative Care; by Joohyun Chung, Aaron Langlois, TylaAnn Burger, David L Chin; 6/11/26 Background: Home-based palliative care (HPC) improves quality of life for individuals with serious illness but remains underutilized in the United States, with persistent disparities in access. HPC is also frequently misconceived as appropriate only at the end of life. ... Results: ... Patients who received HPC were more likely to be older, female, insured through Medicare Part B, and referred from larger hospitals. Conclusion: These findings underscore ongoing structural disparities in access to home-based palliative care and highlight the need for targeted strategies to improve equitable access to HPC services.

Family caregivers' perspectives on challenges and support needs in hospital-based palliative care for persons living with dementia Baylor Medicine | Texas Medical Center Documents ; by Jung Kwak, Anita Chary, Sarah Stayer, Kwaku Duah Oppong, Sumin Yoon, Snehal Patel, and Elizabeth A Kvale; originally pub 11/17/25, reposted online 6/23/26Palliative care needs of hospitalized persons living with dementia (PLWD) and their family caregivers remain poorly understood. ... Thematic analysis of interviews revealed three themes: the value of palliative care in navigating end-of-life uncertainty in dementia, uncoordinated and reactive care during hospitalization, and lack of guidance for post-hospital transitions. While caregivers valued palliative care for emotional and decision-making support, findings underscore the need for earlier integration and improved coordination across hospital teams to better support families.

Caregiving stressors and sleep outcomes: Examining group differences among caregivers of persons living with dementia The Journals of Gerontology; by Fei Wang, Seungjong Cho, Anne Conway, Yejin Heo, Christine Lau, Karyne Machry; 5/26Caring for persons living with dementia often involves high levels of physical demands and emotional burden, which may undermine caregivers’ sleep quality. Few studies have examined sleep health among Black caregivers of persons living with dementia, despite the fact that they are underrepresented in dementia research and experience poorer sleep outcomes compared to non-Hispanic White caregivers. Subjective caregiving stressor (i.e., role overload) was positively associated with sleep disturbance. A significant interaction showed that the association between role overload and sleep disturbance was stronger among Black caregivers than in non-Hispanic White caregivers. Findings also suggest that Black caregivers of persons living with dementia may experience greater vulnerability to the adverse role of role overload in relation to sleep.

Knowledge of advance care planning and advance directives among US adults: Implications for health policy and practicePalliative Care & Social Practice; by Anisah Bagasra, Gretchen Agans; 5/26Advance care planning (ACP) is the process of identifying and communicating values and goals in preparation for future shared decision-making in medical settings. Decisions are legally supported by an advance directive (AD) document designating healthcare agent(s) and future medical treatment preferences. Although important, ACP engagement in the United States remains low. Findings indicate persistent gaps in ACP and AD literacy among US adults, along with misconceptions about access, time, and costs that may be contributing to low engagement. Increasing public education and expanding access to knowledgeable professionals may help reduce barriers and promote more equitable engagement in ACP.

Serious illness care exclusion, disclosure, & trust for older gay men & caregivers in the Deep SouthJournal of Pain & Symptom Management; by Korijna Valenti, Margaret Armstrong, Michael Barnett, Stacy Smallwood, Ronit Elk; 5/26Older gay men in the Deep South experience serious illness within healthcare systems shaped by heteronormativity and structural racism. Although disparities in access and disclosure are documented, less is known about how negative or ambiguous healthcare encounters are interpreted in serious illness settings. Using a community-based participatory research approach, we conducted semi-structured interviews with 16 participants (11 patients aged 50 years or older living with serious illness and 5 caregivers) residing in the Deep South. Five themes emerged: discriminatory experiences and bias, clinician communication gaps, exclusion from decision-making, system-level gaps in care quality, and disclosure, trust, and safety. Participants described overt and subtle forms of bias, dismissal of partners in clinical encounters, rushed or unclear communication, and institutional barriers that intensified vulnerability during serious illness. Black participants more frequently identified racialized experiences and contextualized mistrust within histories of systemic racism.

Connecting through emotions: a social constructivist grounded theory on how palliative care clinicians use their emotions during consultations Journal of General Internal Medicine; by Katrien Moens MSc, Johan Bilsen PhD and Sofia C. Zambrano PhD; 6/15/26 Background: Palliative care clinicians are regularly exposed to emotionally laden situations. While emotions are an intrinsic part of their encounters with patients and relatives, the role of clinicians’ own emotions has remained understudied. Conclusions: Our findings suggest that palliative care clinicians use their strong emotions during consultations to build connection. When met with awareness and reflection, these emotions can serve as a valuable resource for delivering patient- and relationship-centered palliative care. Future research should explore clinicians’ training needs and attitudes towards emotional skills training more broadly.