Advanced clinical simulation to enhance psychosocial competence and communication in end-of-life care: A pre-post study with nursing students

Identifier:  imarina:9525269

Handle: https://hdl.handle.net/20.500.11797/imarina9525269

Authors:  Reverte-Villarroya, Silvia; Grau-Castell, Laia; Gil-Mateu, Elsa; Torrubia-Perez, Elisabet; Vidiella, Astrid; Segura-Meix, Miriam; Palau, Ramon; Adell-Lleixa, Mireia

Abstract:
Background: Developing psychosocial competence, particularly sense of coherence (SOC), alongside communication skills in end-of-life care is a persistent challenge in nursing education. This study examined the impact of advanced clinical simulation on psychosocial competence among nursing students during geriatric care clinical practicums. Methods: A single-group pre-post study involved 50 fourth-year nursing students who completed two advanced simulation sessions. Outcomes were measured using the Sense of Coherence Scale (SOC-13), Professional Health Communication Skills Scale (EHC-PS), Rosenberg Self-Esteem Scale, and satisfaction questionnaire. Results: The meaningfulness dimension of SOC improved significantly (19.56-20.16; p = .001; Cohen's d = 0.48). Communication skills showed mixed results: assertiveness approached significance ( p = .050), while respect decreased significantly ( p = .034). Self-esteem increased slightly (25.38-25.78; p = .149). Satisfaction was consistently high. Regression identified preintervention meaningfulness (beta = 0.321; p = .017) and age ( beta = 0.411; p = 0.007) as predictors of postintervention SOC. Conclusions: Advanced clinical simulation was associated with enhanced psychosocial competencies, particularly the meaningfulness dimension of SOC. The single-group pre-post design limits causal inference. Controlled studies are needed to confirm these associations and determine whether simulation directly enhances SOC. (c) 2026 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)