The Impact of Educational Interventions on Nursing Students' Attitudes Towards End‐of‐Life Care: A Cross‐Sectional Study

AIM: To evaluate nursing students' attitudes towards end-of-life care and assess the impact of an elective educational course on shaping these attitudes. DESIGN: A cross-sectional observational study with a post-test-only design was conducted at the University of Padua in northern Italy. METHODS: The study involved 475 third-year nursing students, with 228 participants (48%) completing an online survey. The validated Frommelt Attitude Toward Care of the Dying Scale, Form B, Italian Version (FATCOD Form B-I) was used, and data were analysed through descriptive statistics, t-tests and correlation analyses. RESULTS: Participants demonstrated overall positive attitudes towards end-of-life care, with a mean FATCOD Form B-I score of 118.65 (SD = 9.63). Female students scored significantly higher in communication (p < 0.001) and family care (p = 0.002) than males. However, no significant differences were found between students who completed the elective palliative care course and those who did not. Fear and discomfort with death negatively influenced relationship building with patients, while communication and active care were strongly correlated (r = 0.45, p < 0.001). CONCLUSION: Although nursing students exhibited generally positive attitudes, the elective course alone was insufficient to significantly enhance preparedness for end-of-life care. A comprehensive, integrated palliative care education programme is necessary to address emotional barriers and improve relational competencies, ensuring students are equipped for compassionate and competent end-of-life care. IMPLICATIONS FOR THE PROFESSION: Although nursing students exhibited generally positive attitudes towards end-of-life care, theoretical instruction alone proved insufficient to significantly enhance their preparedness for palliative care practice. These findings have direct implications for nursing education and clinical care quality: integrating comprehensive, experiential palliative care education throughout nursing curricula, rather than relying on optional standalone courses, may better equip future nurses to deliver compassionate and competent end-of-life care. IMPACT: Despite international recommendations, many nursing students feel unprepared for end-of-life care. This study examined whether an elective palliative care course produces meaningful attitudinal change among final-year nursing students. Students showed generally positive attitudes, with the highest scores in Family care and Communication. No significant difference emerged between students who attended the elective course and those who did not. The findings impact nursing educators and curriculum designers, ultimately benefiting future nurses and the terminally ill patients and families they will care for. REPORTING METHOD: This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for observational studies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.