Effectiveness of scenario-based simulation teaching on advance care planning competencies in geriatric nurses: A quasi-experimental study.

AIM: To compare the effectiveness of scenario-based simulation versus case-based teaching in improving geriatric nurses' multiple competencies for Advance Care Planning (ACP). BACKGROUND: Geriatric nurses are pivotal in ACP but often lack adequate preparedness, necessitating training that addresses both knowledge and behavioral-attitudinal components. Simulation-based education offers a safe environment to develop such complex clinical skills. DESIGN: A quasi-experimental, non-equivalent control group pretest-posttest design. METHOD: Within a provincial geriatric nursing training program in China, 196 nurses were allocated by cohort: 80 to simulation teaching and 116 to case-based teaching. Outcomes were measured at baseline and post-intervention using validated instruments assessing ACP knowledge, communication skills, self-efficacy and practice preference. Analysis included 183 participants after attrition. RESULTS: Groups were comparable at baseline. Both groups improved in ACP knowledge, with no significant between-group differences. However, the simulation group showed significantly greater gains in communication skills, self-efficacy and practice preference (all p < 0.05). Participants also rated the simulation experience highly (Simulation Effectiveness Tool Modified scores: 45.98/57). CONCLUSION: Scenario-based simulation teaching is more effective than case-based teaching in enhancing communication skills, self-efficacy and practice preference for ACP in geriatric nursing, while being equally effective in improving ACP knowledge. Integrating simulation into ACP education is recommended. Future research should employ randomized designs and assess long-term outcomes.