First Advisor

Gilbert, Marcia


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

101 pages


Abstract Background: Thc nurse impacts the EOL journey for both the patient and family members more than any other healthcare provider. Many nurses believe that they are inadequately prepared and lack confidence in providing care to dying patients and family. Research has shown that there are major deficiencies in EOL education for nurses. Design: This Capstone Project assessed the pedagogical effectiveness of utilizing hybrid high fidelity simulation to enhance the self-efficacy of senior level baccalaureate nursing students in caring for dying patients and their families. This innovative educational strategy was evaluated using a descriptive study design to determine the students' level of self-efficacy. Sixty two nursing students completed the Bandura Scale for Self-Efficacy (2006) on three separate occasions; before a didactic presentation; following the didactic presentation; and following the simulation experience. Results: The respondents reported a growth in the mean self-efficacy scores with each wave of completed questionnaires; Baseline, Post-lecture and Post-Simulation. Repeated measures ANOV A results showed a statistically significant linear growth in self-efficacy over the three waves: Data from the Self-Efficacy questionnaires were further analyzed in a repeated measures design using ANCOVA. The covariates for the study included age, spiritual beliefs and previous experience caring for a dying person. When the trend was subjected to consideration of the three covariates, the growth in self-efficacy over the study period ceased to be statistically significant. The level of spiritual belief appears to have interacted with self-efficacy. Those with minimal beliefs showed a decline in selfefficacy between the lecture and the simulation activity. Differences in spiritual beliefs may have as much of an impact on self-efficacy in caring for the dying patient and family as the simulation experience. Nurse educators must be cognizant of the challenge that nurses with minimal spiritual beliefs face when providing holistic care to the dying patient and family. Further investigation is needed in the relationship of confessed spirituality for nursing students and the care of the dying patient.

Date of Award

Spring 2012

Location (Creation)

Denver, Colorado

Rights Statement

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