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Learning Objective 1: Examine the influence of health care professionals' attitudes about age, race, religion, culture and death on End of Life (EOL) knowledge, skills and attitudes.
Learning Objective 2: Plan simulation scenarios that present “disorienting dilemmas” for the participants to become aware of their attitudes, discuss them with others, and gain new perspectives.
Method: PharmD students participated in a High Fidelity simulation that focused on the final minutes of life and interval following. Students and faculty played the roles of health care workers and family. The scenario portrayed a middle aged Hispanic, Catholic, End stage renal patient who had decided to stop dialysis. After the scenario, the students were given time to provide both written and oral reflection of their feelings. Following the reflection, critical discourse occurred among the students and faculty focusing on student feelings related to death, EOL care, cultural and family issues, etc. and how these feelings could impact EOL care. Content analysis was used to analyze student reflections.
Findings: Students identified that their attitudes were influenced by previous personal experiences. As they listened to peers, they reported their perspectives broadened. They also reported that they were better prepared for care of a dying patient.
Conclusion: EOL is a universal phenomenon. Culture and religion play a very important part in all major life events, particularly at EOL. The use of high fidelity simulation via an EOL scenario provides the loom on which the threads of culture and religion are woven resulting in a unique and personalized tapestry that remains an integral part of the family long after the death. Awareness of attitudes and exposure to other ways of thinking and doing will ultimately improve preparation for, and provision of, EOL care for all.