This quantitative, quasi-experimental and correlational study examined changes in 48 senior level, undergraduate nursing students’ resilience and spirituality using the Resilience Scale and Spiritual Intelligence Self-Report Inventory (SISRI-24). The Resilience Scale revealed a Cronbach’s alpha coefficient ranging from 0.85 to 0.94 and an internal consistency ranging from 0.91 to 0.94 in various research studies (Wagnild, 2016). The tool, SISRI-24 demonstrated excellent reliability (α=0.92) and construct validity in 305 undergraduate students (King, 2008). The scales were given before and after the nursing students participated in an end-of-life care simulation, focusing on the care of an older adult patient in the intensive care unit.
There were statistically significant changes in the nursing students’ resilience when comparing pre (M=139.02, SD=14.07) and post participation in the simulation (M=142.27, SD=15.22), t(47)=2..99, p=0.004 (two-tailed). There were statistically significant changes in spirituality scores on the SISRI-24 from pre-simulation (M=62.44, SD=13.28) to post-simulation (M=67.00, SD=13.54), t(47)=5.54, p=0.000 (two-tailed). Upon further inspection of the relationship between resilience and spirituality, a statistically significant (p<0.001) weak (r=0.482) to moderately (r=0.530) positive correlation occurred in resilience and spiritualty in the nursing students pre and post simulation scores. Cohen’s d statistic (d=<0.34) indicated small effect sizes across all statistically significant findings.
The undergraduate nursing students experienced gains in resilience, spirituality, and the correlational relationship between resilience and spirituality after participating in the end-of-life care simulation. As such, incorporating an end-of-life care simulation within undergraduate nursing curriculum is of value. The Robert Wood Johnson Foundation (2014) found that nearly one in five newly graduated nurses leave the profession within the first year; this statistic highlights the need for nursing programs to assist students in building their resilience and spirituality. Of particular importance, the need for up-and-coming nurses to have the opportunity to have exposure to end-of-life care is necessary as the psychological and emotional demands placed on nurses places their resilience at risk (Scammell, 2017). Nursing education, including simulation, offers a safe environment for holistic learning to occur, including addressing psychological and spiritual needs.