Overcoming Fear of Death through Clinical Simulation in Nursing Education. A quasi-experimental longitudinal design

The increase in life expectancy has led to a rise in chronic and degenerative diseases, often necessitating palliative care for individuals in the final stages of life. Despite advancements in medical technology, the need for skilled nurses in end-of-life care remains crucial. A quasi-experimental design was used to assess changes in attitudes toward death before, after theoretical training, and after simulation sessions. Participants were third-year nursing students enrolled in a 6 ECTS palliative care course, consisting of lectures, seminars, and practical simulation exercises. Fear of death was measured using the Collett-Lester Fear of Death Scale (CLFDS). Results indicated that students initially exhibited high levels of fear, which decreased in most subscales after training, especially regarding the fear of one's own death and the death of others. However, students' fear of their own dying process increased, likely due to heightened awareness of mortality. Women showed higher levels of fear than men, and age was negatively correlated with fear across several dimensions. The study suggests that incorporating clinical simulation into palliative care education helps nursing students develop emotional preparedness and practical skills for providing end-of-life care. This approach bridges the gap between theoretical knowledge and clinical practice, enhancing the competence and confidence of future nurses in managing palliative care situations.