Sunday, 18 September 2016
The likelihood that a nurse will care for a patient during the end of life is increasing. Yet, new graduate nurses continue to feel unprepared to care for them. While there is little disagreement that end of life education should be integrated in the curriculum, the evidence is unclear on the most effective way to accomplish it. This comparative study was designed to determine if a difference exists between providing education on end of life in a classroom-based learning experience versus receiving the same experience through a patient simulation lab. Both interventions used the National League for Nursing’s Advancing Care Excellence for Seniors unfolding end of life toolkit. The unfolding case was developed to provide an evolving case-based scenario, which was designed to be unpredictable to the learner. Through the unfolding case, the power of combining patient simulation with storytelling enhances the student’s overall learning experience. In an attempt to maintain the ACE.S’ toolkit integrity, there were no significant changes made to the tool during either the classroom or the sim lab portion of the study. A total of 49 undergraduate nursing students participated in the study, with a 100% response rate. The students’ attitudes were captured before and after the interventions using the Frommelt Attitude Toward Care of the Dying Scale (FATCOD), Form B. The FATCOD is a 30-question survey designed to assess the attitudes of individuals caring for a patient and their family during end of life and uses a 5-point Likert-type scale. While the study did not find a statistical significance in the overall mean score of either intervention, there was an increase from the pre-survey (4.14 ± 0.87) to the classroom intervention (4.20 ± 0.88) (P = 0.56) and even higher in the simulation lab (4.32 ± 0.81) (P = 0.07). It can be concluded that, while the study failed to show a statistical significance as a whole, providing education on end of life is beneficial in the classroom, but even more so in patient simulation lab.
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