Academic journal article Nursing Education Perspectives

The Development, Implementation, and Evaluation of an End-of-Life Simulation Experience for Baccalaureate Nursing Students

Academic journal article Nursing Education Perspectives

The Development, Implementation, and Evaluation of an End-of-Life Simulation Experience for Baccalaureate Nursing Students

Article excerpt


AIM This article presents an example of a high-fidelity end-of-life simulation developed for an elective course in a baccalaureate nursing program.

BACKGROUND Nursing education programs often lack opportunities for palliative care experiences in undergraduate education. Simulation offers an alternative learning strategy for nursing students to apply principles of palliative care and communication in a safe, interactive learning environment.

METHOD An end-of-life simulation for senior nursing students was developed, implemented, and evaluated. Following participation in the simulation, students evaluated educational practices and their satisfaction and confidence in learning. They also completed reflection papers on their learning.

RESULTS Student means for items on educational practices and satisfaction and confidence in learning were all between agree and strongly agree on a 5-point scale of agreement (n = 21).

CONCLUSION The end-of-life simulation experience created an opportunity for nursing students to gain confidence in their ability to provide palliative nursing care.


Simulation--End-of-Life Nursing Education --Evaluation--Principles of Palliative Care


Although nurses are present with many patients at the end of life, undergraduate nursing programs often fail to adequately prepare nurses to care for dying patients and their families (Dunn, Otten, & Stephens, 2005). Simulation is an effective tool for providing end-of-life (EOL) nursing education in an interactive learning environment. Simulations provide a safe environment for learning and create a bridge between the unknown of caring for a dying patient and skill development in effectively communicating with patients and families (Bambini, Washburn, & Perkins, 2009; Smith-Stoner, 2009).

Educating undergraduate nursing students in the care of dying patients is particularly critical as the population ages and the existence of chronic health conditions increases in the United States. This article describes the development, implementation, and evaluation of an EOL nursing care simulation experience for baccalaureate nursing students.


Historically, nurses have received a paucity of education specific to caring for dying patients, and this trend continues in undergraduate nursing programs today (Robinson, 2004). Nursing students report they feel anxious and lack competence in caring for dying patients (Kwekkeboom, Vahl, & Eland, 2006). Studies indicate that nurses spend more time with patients at the end of life than any other health care professional (Moreland, Lemieux, & Myers, 2012; Wallace et al., 2009). When providing EOL care, students have the opportunity to understand the value of holistic care, learn the need to care without judgment, and realize the importance of family member involvement throughout the dying process (Leighton & Dubas, 2009).

Traditional teaching of EOL nursing care has occurred in the classroom and is often placed within course content for adults, children, and community health (Allchin, 2006). However, students may not have an opportunity to care for a dying patient and family in the clinical setting. Despite the expectation that nurses have both the skills and knowledge to care for dying patients, without direct patient and family interactions, students cannot adequately prepare for this critical role (Brajtman, Fothergill-Bourbonnais, Fiset, & Alain, 2009).

The American Association of Colleges of Nursing (AACN) recommended competencies and curricular guidelines for EOL nursing care in 1998 (2008). In 2000, the organization published the End of Life Nursing Education Consortium Core Curriculum and began training nursing faculty how to teach and implement EOL content throughout nursing education programs (Matzo, Sherman, Sheehan, Ferrell, & Penn, 2003). …

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