Bringing the Background to the Foreground in Nursing Education: Appreciating Nursing Students’ Backgrounds in an End-Of-Life Care Simulation

Background: Multiple healthcare agencies, such as American Association of Colleges of Nursing (2016) and American Nurses’ Association (2017), requested that end-of-life care be incorporated in undergraduate nursing education. Simulation offers nursing educators the opportunity to offer safe, hands-on end-of-life care education. However, a gap in the literature exists when examining the impact of the simulator and nursing students’ backgrounds on their stress. Objective: To examine the relationship between patient-type simulator and undergraduate nursing students’ previous professional role exposure to individuals in high crisis on psychological and physiological stress. Methods: The quantitative, quasi-experimental study involved analysis of physiological and psychological stress in 159 participants observing or actively providing care to a simulated end-of-life care patient. Further analysis involved assessing the impact of previous professional background exposure to individuals in high crises on stress levels. Psychological stress was analyzed through percentage changes in the State Trait Anxiety Inventory (STAI), Form Y-1; physiological stress was analyzed through percentage changes in heart rate, systolic and diastolic blood pressure. Results: Overall greater psychological stress occurred when patient care involved the high-fidelity mannequin. Whereas, the greatest change in heart rate occurred in those with no professional exposure to individuals in high crises when care involved the standardized patient. However, the greatest percentage change in blood pressure occurred in those engaged with the care of the standardized patient. Conclusion: There was a relationship between undergraduate nursing student stress, choice of patient simulator, and previous professional role exposure to individuals in high crises. Keywords: End-of-life Care; Simulation; Nursing Education; Stres