When the Simulator Dies: Experiential Education About Death Designed for Undergraduate Nursing Students
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Background and Objectives: Graduates from undergraduate nursing programs report inadequate death education. Most death education is focused on end-of-life care and taught by lecture. Students are not provided opportunities to reflect on their own feelings about death. Due to lack of clinical nursing faculty and shortage of clinical sites, students are spending less time in clinical experience and hence have fewer opportunities to experience patient death. This inadequate education can negatively impact patient care and may lead to an increase in turnover for recent graduates. Lack of proper training can cause inadequate communication of death to family members, which in turn can negatively impact family grieving. This study investigated the impact of an experiential learning strategy using high fidelity simulation to teach undergraduate nursing students about unexpected patient death. Methods: Senior nursing students were randomly assigned to a rescue or failure-to-rescue simulation scenario. Outcome measures included: (a) knowledge pre and post simulation, (b) cognitive load pre and post debriefing, (c) emotion pre and post debriefing, and (d) student self-confidence and satisfaction in learning. Data analyses included comparative statistics, t-tests, and two-way analysis of variance. Results: Three major findings are discussed: (1) no difference in knowledge gain between rescue and failure-to-rescue groups, (2) overall more negative emotional affect for failure-to-rescue group immediately following simulation, but no difference between groups following debriefing, and (3) no difference in satisfaction and self-confidence in learning between rescue and failure-to-rescue groups.