Impact of simulation-based learning experiences on enhancing coping with death in nursing students: An experimental study

<h2>Abstract</h2><h3>Introduction</h3> Fear of death poses a significant psychological challenge for nursing students, often hindering their abilities to provide effective end-of-life care. Developing coping mechanisms to address this fear is crucial for their professional growth. Simulation-Based Learning Experiences (SBLE) offer a novel pedagogical approach, enabling students to engage with death-related scenarios in a safe and controlled environment. <h3>Objectives</h3> This study aimed to assess baseline levels of fear of death among nursing students and evaluate the effectiveness of SBLE in reducing this fear and enhancing their ability to cope with mortality, compared to traditional classroom instruction. <h3>Methods</h3> A total of 240 second-year nursing students from the University of Extremadura participated in this randomized experimental study. Participants were allocated to either an intervention group, which underwent SBLE, or a control group receiving traditional classroom instruction. Data were collected at baseline (T0) and postintervention (T1) using the Collett-Lester Brief Fear of Death Scale (BFDS) and Bugen's Coping with Death Scale (CDS). Paired t-tests and repeated measures ANOVA were employed for statistical analysis. <h3>Results</h3> At baseline, both groups exhibited moderate levels of fear of death, with no significant differences. Postintervention, the SBLE group showed a significant increase in coping ability (CDS mean score: 109.16-132.35, <i>p</i> < .001) and a reduction in fear of death, compared to the control group (CDS mean score: 109.34- 118.94, <i>p</i> < .001). Repeated ANOVA measures confirmed the superiority of the SBLE approach (<i>p</i> < .001). <h3>Conclusion</h3> SBLE effectively reduces nursing students' fear of death and strengthens their coping mechanisms. By integrating reflective and experiential learning, SBLE enhances emotional resilience and prepares students for the challenges of end-of-life care, underscoring its importance in nursing education curricula.