Implementing and evaluating a comprehensive simulation-based program to enhance nursing students’ coping with death, burnout, and communication skills

Background/objectives: Current reforms in higher education emphasize the need for active student engagement as a key element of competency-based learning. Within nursing education, simulation-based learning experiences (SBLE) provide an effective pedagogical strategy to integrate practical and emotional skills, especially in palliative care contexts. This study aimed to implement and evaluate a comprehensive simulation-based educational program designed to enhance nursing students' coping with death, reduce burnout, and improve communication skills, thereby fostering compassionate and emotionally competent care. Methods: A program evaluation design with a one-group pretest-posttest educational intervention was employed in accordance with the TREND statement. Participants were second-year undergraduate nursing students. Baseline measures assessed fear of death and emotional intelligence. The intervention included pre-briefing sessions on death, burnout, and communication with terminal patients, followed by simulation and debriefing phases. Outcomes included students' coping capacity with death, burnout levels (emotional exhaustion, cynicism, and self-efficacy), communication skills in clinical interactions, and satisfaction with SBLE. Results: < 0.001), reductions in emotional exhaustion and cynicism, and increased self-efficacy. Communication skills improved notably, supported by both instructor evaluations and student self-assessments. Overall satisfaction with the SBLE was high. Conclusion: Simulation-based learning effectively enhances nursing students' emotional preparedness, coping capacity, and communication competence while reducing burnout. These outcomes support the integration of SBLE into nursing curricula to foster compassionate, resilient, and skilled professionals in end-of-life and emotionally demanding care settings.