title: Reported clinical outcomes of high-fidelity simulation versus classroom-based end-of-life care education.
abstract: BACKGROUND
  Nursing students often experience increased anxiety, lack of clinical skills and poor coping mechanisms when dealing with death and dying for the first time.
  
  
  OBJECTIVE
  To design, use and assess the effectiveness of high-fidelity simulation teaching versus classroom-based end-of-life care (EoLC) teaching for first-year nursing students on dealing with their first death experiences in clinical placements.
  
  
  METHODS
  A qualitative phenomenography approach was taken. First-year nursing students (n=187) were randomly allocated to receive either classrtoom-based (n=139) or high-fidelity simulation-based EoLC teaching (n=48). When all participants had returned from their first clinical placement, 12 individual in-depth interviews were carried out. Data were analysed using framework analysis.
  
  
  RESULTS
  Comparative data analysis revealed four key themes as clinical outcomes: recognising death and dying; knowledge into practice; preparedness for clinical eventualities; and emotional preparedness.
  
  
  CONCLUSIONS
  Despite the fact that both strategies improved students' knowledge of EoLC, simulation-based EoLC education was perceived as better in terms of enhanced practical skills and improved emotional experience in their first clinical placement.
authors.affiliation: Senior Lecturer in Adult Nursing, University of Bedfordshire, Aylesbury, UK.
authors.forename: Munikumar Ramasamy
authors.initials: MR
authors.lastname: Venkatasalu
authors.forename: Michael
authors.initials: M
authors.lastname: Kelleher
authors.forename: Chun Hua
authors.initials: CH
authors.lastname: Shao
mesh_terms: D001293:Attitude to Death; D003479:Curriculum; D004506:Education, Nursing / Q000458:organization & administration*; D006801:Humans; D013338:Students, Nursing / Q000523:psychology; D013727:Terminal Care
keywords: Clinical outcomes; End-of-life care; High-fidelity simulation; Learning; Phenomenography; Teaching