Boosting Nursing Student Competence and Confidence in Providing End-of-Life Care

End-of-life care can be challenging for nursing students, especially when they navigate emotional situations and difficult conversations with patients and families. Guided by Benner’s Novice to Expert theory, we wanted to determine whether intentionally combining end-of-life didactic education with simulation could improve students’ knowledge, confidence, and emotional readiness.

Students completed surveys before and after participating in a structured end-of- life lecture and simulation. Following the intervention, confidence improved, and 60% of students reported high emotional readiness to provide end-of-life care. Students also demonstrated strong knowledge, with 97% correctly identifying goals of end-of-life care and appropriate responses to a patient expressing fear.

One of our most interesting findings was that students’ concerns shifted. Before the intervention, many worried about not having enough knowledge. After the intervention, their concerns shifted to navigating difficult conversations with patients and families.

Our findings suggest that didactic education and simulation can build a strong foundation, but students need continued opportunities—particularly through high-fidelity simulation—to practice the communication skills required to provide compassionate, confident end-of-life care.