Abstract

Background: End-of-life (EOL) care is a vital yet often underemphasized component of nursing education. Limited clinical opportunities to engage with dying patients can leave nursing students unprepared to provide compassionate care. High-fidelity simulation provides an evidence-based, immersive learning environment that allows students to practice communication, decision-making, and emotional responses in a safe setting.

Research Question/Aims: This study aimed to determine whether participation in a high-fidelity simulation focused on EOL care would improve nursing students’ attitudes toward caring for dying patients. It was hypothesized that simulation participation would positively impact student attitudes as measured by a validated instrument.

Methods: A quantitative pretest–posttest design was utilized with a convenience sample of 14 prelicensure nursing students. Students completed the Frommelt Attitudes Toward Care of the Dying Scale, Form B (FATCOD-B) immediately before and after participating in a high-fidelity EOL simulation. The simulation included patient deterioration, family interaction, and care transitions. Data were analyzed using the Wilcoxon Signed Rank Test to assess changes in median scores.

Results: Median FATCOD-B scores improved from 117.5 pre-intervention to 123 post-intervention. Statistical analysis revealed a significant improvement in student attitudes (z = -2.98, n = 14, p < .05), with a small effect size (r = .11). These results supported the study hypothesis, indicating that high-fidelity simulation is effective in improving attitudes toward EOL care.

Conclusion: High-fidelity simulation positively influenced nursing students’ attitudes toward caring for dying patients. Even a single exposure demonstrated measurable change, suggesting that simulation can address educational gaps in EOL training. Integration of structured EOL simulations into nursing curricula may better prepare students to provide empathetic, patient-centered care to dying individuals and their families.

Notes

Presenter notes available in attached slide deck.

References included in attached slide deck.

Description

Focus: Academic

Completed Work/Project

This study examined the effect of high-fidelity simulation on nursing students’ attitudes toward end-of-life care. Using a pretest–posttest design with the FATCOD-B scale, 14 students demonstrated a significant improvement in attitudes after participating in a simulated patient decline scenario. Findings suggest that simulation is an effective strategy to enhance student readiness for compassionate end-of-life care, with implications for nursing education, practice, and policy.

Author Details

Meredith Joyner, DNP, RN, CNE, CHSES, CHSOS, CNORe - Assistant Professor and Simulation Lab Manager, Johnson & Wales University

Sigma Membership

Chi Alpha at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Pretest-Posttest

Research Approach

Quantitative Research

Keywords:

Simulation, Hospice, Palliative, End-of-Life, Implementation Science

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

2026-07-20

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Impact of High-Fidelity Simulation on Nursing Students’ Attitudes Toward Care of the Dying

Toronto, Ontario, Canada

Background: End-of-life (EOL) care is a vital yet often underemphasized component of nursing education. Limited clinical opportunities to engage with dying patients can leave nursing students unprepared to provide compassionate care. High-fidelity simulation provides an evidence-based, immersive learning environment that allows students to practice communication, decision-making, and emotional responses in a safe setting.

Research Question/Aims: This study aimed to determine whether participation in a high-fidelity simulation focused on EOL care would improve nursing students’ attitudes toward caring for dying patients. It was hypothesized that simulation participation would positively impact student attitudes as measured by a validated instrument.

Methods: A quantitative pretest–posttest design was utilized with a convenience sample of 14 prelicensure nursing students. Students completed the Frommelt Attitudes Toward Care of the Dying Scale, Form B (FATCOD-B) immediately before and after participating in a high-fidelity EOL simulation. The simulation included patient deterioration, family interaction, and care transitions. Data were analyzed using the Wilcoxon Signed Rank Test to assess changes in median scores.

Results: Median FATCOD-B scores improved from 117.5 pre-intervention to 123 post-intervention. Statistical analysis revealed a significant improvement in student attitudes (z = -2.98, n = 14, p < .05), with a small effect size (r = .11). These results supported the study hypothesis, indicating that high-fidelity simulation is effective in improving attitudes toward EOL care.

Conclusion: High-fidelity simulation positively influenced nursing students’ attitudes toward caring for dying patients. Even a single exposure demonstrated measurable change, suggesting that simulation can address educational gaps in EOL training. Integration of structured EOL simulations into nursing curricula may better prepare students to provide empathetic, patient-centered care to dying individuals and their families.