Effect of a High-Fidelity End-of-Life Simulation on Nursing Students’ Death Anxiety
Gee, Rose Mary
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Background: Many nursing students report feeling high anxiety about providing End-of-Life (EOL) nursing care (Hamilton, 2010). Traditional teaching formats are not best suited to provide students opportunities to reflect on their feelings and concerns (Gillan et al., 2014). New educational approaches are necessary to promote experiential learning and reflection (Benner et al., 2009). Purpose: This quasi-experimental study examined the effect of an EOL simulation on nursing students’ death anxiety and concerns about death and dying prior to attending a hospice clinical. Methods: The Concerns about Dying (CAD) instrument was administered to two undergraduate nursing class cohorts (n = 86). A 2x2 factorial mixed-model ANOVA [(semester: Fall, Spring) x (Treatment: Simulation, Hospice)] was conducted to assess the effects of semester and treatment on students’ CAD scores. Results: Neither the semester x treatment type interaction nor the main effect for semester reached statistical significance. However, the CAD mean scores for the fall cohort significantly decreased from pre- to post-simulation and from post-simulation to after hospice, with a large effect. The CAD mean scores for the spring cohort did not significant decrease between pre- and post-simulation; however, there was a significant decrease in CAD score between post-simulation and after hospice, with a large effect. Conclusion: Overall, the students’ reported less anxiety about caring for dying patients after the EOL simulation and a further decline in their death anxiety after the hospice experience. The students’ decreased death anxiety trend is encouraging and an EOL simulation should be considered to decrease nursing students’ death anxiety.