Abstract
Background: Organ donation is a critical healthcare priority, with 140,964 transplants performed worldwide in 2018 (Lewis et al., 2021). Nursing students often report limited exposure to donor referral processes, brain death determination, and communication with organ procurement organizations. Low baseline knowledge and confidence highlight the need for structured educational interventions (Alwesmi et al., 2023; Bertocchi et al., 2025). Evidence shows teaching and simulation-based learning enhance knowledge, attitudes, and competence in end-of-life donation care (Lewis, 2023). Simulation provides psychological safety, supporting teamwork, communication, clinical judgment, and emotional readiness for ethically complex situations (Masgaard & Svellingen, 2025).
Purpose/Methods: This study examined senior undergraduate nursing students’ perceptions, knowledge, and learning experiences following an organ donation simulation. A mixed-methods, quasi-experimental pretest–posttest design involved 44 students in a fourth-semester critical-care course. Students completed pre-simulation readings, reviewed an ICU handoff report, and engaged in a facilitator-guided, video-based simulation depicting a 51-year-old patient’s progression to brain death. Interprofessional collaboration included acute care nurse practitioner students and an organ procurement representative. Pre- and post-simulation surveys and open-ended reflections assessed knowledge, communication, and ethical awareness.
Results: Fisher’s Exact Test showed no statistically significant differences; descriptive results indicated positive shifts across all domains. Qualitative findings revealed increased ethical awareness, appreciation for interprofessional coordination, and improved communication strategies, including “bridging language” in difficult family conversations. Students reported clearer understanding of their role in caring for brain-dead patients and deeper insight into the donation process, recommending additional hands-on and interprofessional opportunities.
Conclusion: Organ donation simulation supports development of clinical judgment, communication, and ethical reasoning in end-of-life care and donor referral. Procurement-focused simulation may enhance readiness for practice and improve quality and safety outcomes. Future research should include larger samples and explore immersive, high-fidelity simulation to advance nursing education best practices.
Notes
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References:
Alwesmi, M. B., Alharbi, A. I., Alsaiari, A. A., Abu Alreesh, A. E., Alasmari, B. A., Alanazi, M. A., Alanizi, M. K., Alsaif, N. M., Alanazi, R. M., Alshdayed, S. A., & Alabbasi, Y. (2023). The Role of Knowledge on Nursing Students' Attitudes toward Organ Donation: A Cross-Sectional Study. Healthcare (Basel, Switzerland), 11(24), 3134. https://doi.org/10.3390/healthcare11243134
Bertocchi, L., Petrucci, C., Calzetta, M. A., Dante, A., Curcio, F., Lancia, L., & Aviles Gonzalez, C. I. (2025). Knowledge and Attitudes Toward Organ Donation and Transplantation Among Nursing Students: A Multicentre Cross-Sectional Study. Nursing Reports, 15(6), 181. https://doi.org/10.3390/nursrep15060181
Lewis, A., Koukoura, A., Tsianos, G., Gargavanis, A., Nielsen, A., & Vassiliadis, E. (2021). Organ donation in the US and Europe: The supply vs demand imbalance. Transplantation Reviews, 35(2). https://doi.org/10.1016/j.trre.2020.100585
Lewis, S. S. (2023). A study to assess the effectiveness of planned teaching programme on knowledge regarding organ donation among final year diploma nursing students. International Journal of Advance Research in Medical Surgical Nursing, 5(1), 04-07. https://doi.org/10.33545/surgicalnursing.2023.v5.i1.117
Madsgaard, A., Svellingen, A. (2025). The benefits and boundaries of psychological safety in simulation-based education: an integrative review. BMC Nurs 24, 922. https://doi.org/10.1186/s12912-025-03575-y
Sigma Membership
Beta Phi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Quasi-Experimental Study, Other
Research Approach
Mixed/Multi Method Research
Keywords:
Ethics, Interprofessional and Interdisciplinary, Hospice, Palliative or End-of-Life, Nursing Education, Nursing Students, Organ Donation, Simulations, Nursing Ethics
Recommended Citation
Smith, Miranda M.; Miasek, Melissa; Dunaway, Laura; Chamness, Joseph; Deason, Mary; and Modi, Shikha, "Developing Ethical Reasoning and Teamwork in Nursing Students via Organ Donation Simulation" (2026). International Nursing Research Congress (INRC). 246.
https://www.sigmarepository.org/inrc/2026/presentations_2026/246
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-29
Developing Ethical Reasoning and Teamwork in Nursing Students via Organ Donation Simulation
Toronto, Ontario, Canada
Background: Organ donation is a critical healthcare priority, with 140,964 transplants performed worldwide in 2018 (Lewis et al., 2021). Nursing students often report limited exposure to donor referral processes, brain death determination, and communication with organ procurement organizations. Low baseline knowledge and confidence highlight the need for structured educational interventions (Alwesmi et al., 2023; Bertocchi et al., 2025). Evidence shows teaching and simulation-based learning enhance knowledge, attitudes, and competence in end-of-life donation care (Lewis, 2023). Simulation provides psychological safety, supporting teamwork, communication, clinical judgment, and emotional readiness for ethically complex situations (Masgaard & Svellingen, 2025).
Purpose/Methods: This study examined senior undergraduate nursing students’ perceptions, knowledge, and learning experiences following an organ donation simulation. A mixed-methods, quasi-experimental pretest–posttest design involved 44 students in a fourth-semester critical-care course. Students completed pre-simulation readings, reviewed an ICU handoff report, and engaged in a facilitator-guided, video-based simulation depicting a 51-year-old patient’s progression to brain death. Interprofessional collaboration included acute care nurse practitioner students and an organ procurement representative. Pre- and post-simulation surveys and open-ended reflections assessed knowledge, communication, and ethical awareness.
Results: Fisher’s Exact Test showed no statistically significant differences; descriptive results indicated positive shifts across all domains. Qualitative findings revealed increased ethical awareness, appreciation for interprofessional coordination, and improved communication strategies, including “bridging language” in difficult family conversations. Students reported clearer understanding of their role in caring for brain-dead patients and deeper insight into the donation process, recommending additional hands-on and interprofessional opportunities.
Conclusion: Organ donation simulation supports development of clinical judgment, communication, and ethical reasoning in end-of-life care and donor referral. Procurement-focused simulation may enhance readiness for practice and improve quality and safety outcomes. Future research should include larger samples and explore immersive, high-fidelity simulation to advance nursing education best practices.
Description
Organ donation is a healthcare priority, yet nursing students often lack exposure to donor referral and brain death care. A simulation with interprofessional collaboration (n = 44) improved knowledge, communication, ethical awareness, and understanding of donation. Students recommended more hands-on opportunities. Findings support simulation to enhance clinical judgment and ethical reasoning in end-of-life care.