Document Type

Thesis - Open Access

Award Date


Degree Name

Master of Science (MS)

Department / School

Graduate Nursing

First Advisor

Leann Horsley


education, end-of-life care, nursing, simulation


Undergraduate nursing programs have historically glossed over end-of-life care, if their curricula addressed it at all. This lack of instruction can leave practicing nurses feeling poorly prepared to deliver this specialized care. Feeling incompetent and lacking confidence may lead to poorer attitudes regarding this nursing specialty. Thus, effective continuing education activities are paramount in equipping nurses to provide this care and improve attitudes towards caring for terminally ill patients and their families. The purpose of this study was to examine how registered nurse attitudes towards end-of-life care are impacted using a simulation-based learning experience compared to a traditional face-to-face lecture instructional format. A pretest-posttest control group design was used to compare the face-to-face lecture with the simulation-based learning experience. The Frommelt Attitudes Toward Care of the Dying – Form B was used to measure nurse attitudes before and after the intervention. A repeated measures analysis of the two-group pretest-posttest was conducted. Nurse attitudes increased significantly (p = 0.003) in both the simulation and lecture group; there was no significant (p = 0.879) difference between the groups’ increase in attitude. Both face-to-face lecture and simulation are effective in improving nurse attitudes towards end-of-life care and should be considered when designing continuing education activities.

Library of Congress Subject Headings

Nursing -- Study and teaching (Continuing education)
Terminal care -- Study and teaching.
Nursing -- Study and teaching -- Simulation methods.
Computer simulation.
Lecture method in teaching.



Number of Pages



South Dakota State University



Rights Statement

In Copyright