DNP Projects

Jodi Olson

Date of Award

7-27-2025

Document Type

Graduate Paper

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Mary Pesch

Second Advisor

Carrie Hoover

Abstract

Background
End-of-life (EOL) care is a challenging yet essential aspect of nursing practice. Nursing students often report low confidence and competence in managing culturally and spiritually diverse EOL scenarios. Simulation-based learning has proven to be effective in enhancing students' preparedness for complex clinical situations.

Purpose
This project aimed to evaluate the impact of a high-fidelity, culturally, and spiritually diverse EOL simulation on undergraduate nursing students’ perceived competence in delivering culturally sensitive EOL care.

Methods
A quantitative pre/post design was used with a convenience sample of 50 junior-year nursing students enrolled in a chronic care management course. Students participated in a culturally diverse EOL simulation involving Catholic Caucasian, Muslim Somali, and Mide Ojibwe scenarios. The CARES Perceived Competence Measure 2.0, along with an additional question on advance care planning, was administered before and after the simulation. Data was analyzed using descriptive statistics and Wilcoxon signed-rank tests.

Results
Fifty students completed both pre- and post-surveys. Statistically significant improvements were observed across all survey items (α=0.05), with the most significant increases related to providing culturally sensitive care and discussing advance care planning. The simulation experience increased students’ confidence and perceived competence in EOL care.

Conclusion
A high-fidelity EOL simulation that incorporates cultural and spiritual diversity significantly enhances nursing students’ perceived competence in EOL care. Integrating such experiential learning into nursing curricula is essential to developing culturally competent future nurses.

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