Doctor of Philosophy (Ph.D.), University of Dayton, 2021, Educational Leadership

The capabilities of modern medicine have precluded the sanctity of what it means to die, extending life while too often prolonging suffering along a trajectory of functional decline that typifies terminal illness, leaving patients with little say in how they want to experience their final days (Connors et al., 1995). End-of-life care has evolved to ensure that people with terminal illnesses know what to expect, understand their options, and have a voice in their care. It is the nurse-patient relationship at the bedside where patients express their wishes and the opportunity to advocate for patient-directed end-of-life care occurs. Unfortunately, these nurses often are not prepared for this role, cognitively or attitudinally. With an aging generation of baby boomers and prevalence of chronic illness, the need for nurses to be comfortable with end-of-life caregiving is urgent. This requires nurses to be educated in the principles of end-of-life care and possess attitudes conducive to putting their knowledge into practice. Often, though, nurses are confronted with their own attitudinal barriers toward death and dying borne of experiences in life that must first be overcome to freely empower their patients' voices and choices for care. Using a correlational design, the intent of this study was to learn how to improve nursing education in end-of-life care by determining the relationship between undergraduate student nurses' personal, didactic, clinical, and introspection life experiences with death and dying and their attitudes toward providing care to the dying. The study found that the personal, clinical, and introspective domains were associated with attitudes toward care of the dying with introspection showing the strongest correlation with attitudes. Forward regression, however, revealed that all four domains were predictive of attitudes toward care of the dying. Didactic experiences indirectly predicted attitudes by en (open full item for complete abstract)

Committee: Charles Russo J.D., Ed.D (Advisor) Subjects: Nursing

PHD, Kent State University, 2020, College of Education, Health and Human Services / School of Foundations, Leadership and Administration

The purpose of this study was to examine the effect of roles (active vs. passive) and assignment methods (instructor vs. self) on measures of basic science/anatomy and physiology (A&P) knowledge and self-confidence of junior level BSN pre-licensure students who participate in a simulation. Previous research has not examined the potential impact of different role assignment methods on self-confidence or basic science knowledge after a simulation. A nonequivalent, pretest-posttest design was used to examine the impact of roles and assignment methods in simulation. A&P knowledge was evaluated by performance on an A&P assessment and self-confidence was evaluated with the Simulation Effectiveness Tool&mdashModified (SET-M) instrument. A pilot study was conducted with nursing students to determine procedural logistics and baseline statistics. Main study participants included students who completed the simulation and posttest items (N = 108) with 24 completing the pretest, simulation, and posttest. Results suggest no significant differences in A&P knowledge or self-confidence based upon role or assignment method. Prebriefing scores were impacted by assignment method, though no differences were found with the SET-M and other subscales. Significant differences in Prebriefing and Debriefing scores were found among the variables of participants' A&P course grade, exposure to CHF clinically, and age. Correlations between the A&P posttest and the SET-M and subscales were found among age groups and CHF clinicals. These findings suggest prebriefing and debriefing effectiveness are viewed differently based upon age and clinical exposure of which educators may need to be cognizant when designing a simulation learning space.

Committee: Mark Kretovics (Committee Chair); Christa Porter (Committee Co-Chair); Jason Schenker (Committee Member) Subjects: Anatomy and Physiology; Education; Nursing