Enhancing end-of-life communication in Chinese first-year nursing students: A mixed-methods study of a culturally tailored experiential course grounded in Kolb’s experiential learning theory

IF 4 3区医学 Q1 NURSING

Nurse Education in Practice Pub Date : 2026-05-01 Epub Date: 2026-04-24 DOI:10.1016/j.nepr.2026.104842

Jingcheng Wang , Jinyang Geng , Chengcheng Pei , Hongyu Zhao , Keyuan Peng , Chenglei Hu , Josephine Hegarty , Pingting Zhu

{"title":"Enhancing end-of-life communication in Chinese first-year nursing students: A mixed-methods study of a culturally tailored experiential course grounded in Kolb’s experiential learning theory","authors":"Jingcheng Wang , Jinyang Geng , Chengcheng Pei , Hongyu Zhao , Keyuan Peng , Chenglei Hu , Josephine Hegarty , Pingting Zhu","doi":"10.1016/j.nepr.2026.104842","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><div>To develop and evaluate a culturally sensitive end-of-life communication course for first-year nursing students, grounded in Kolb’s experiential learning theory.</div></div><div><h3>Background</h3><div>Global ageing and multimorbidity have intensified the need for effective end-of-life communication, but in China, cultural taboos and limited training hinder its development.</div></div><div><h3>Design</h3><div>A quasi-experimental, cluster-randomized mixed-methods study was conducted.</div></div><div><h3>Methods</h3><div>A total of 114 first-year nursing students across four classes were cluster-randomized into an intervention (n = 59; EOLC course) or control group (n = 55; traditional lectures). Pre- and post-tests and between-group comparisons were used to assess learning outcomes. Reflective writings from the intervention group were analysed qualitatively using content analysis.</div></div><div><h3>Results</h3><div>Post test comparisons showed significant improvements in communication knowledge (MD = 4.36, <em>p</em> = 0.003) and skills (MD = 4.34, <em>p</em> = 0.001). Compared with the control group, the intervention group showed significantly greater improvements in end-of-life care attitudes (<em>β</em> = 7.29, <em>p</em> = 0.028) and positive attitude toward communication skills learning (<em>β</em> = 3.43, <em>p</em> = 0.012). However, the intervention group’s attitude toward caring for the dying person’s family significantly decreased after the program (MD = - 1.19, <em>p</em> < 0.05). Qualitative analysis complemented the quantitative findings, revealing five themes that reflected students’ evolving understanding and professional development.</div></div><div><h3>Conclusions</h3><div>Within the context of this study, an experiential, culturally tailored end-of-life communication course was associated with enhanced nursing student competencies and attitudes. These findings suggest that introducing such programmes earlier in training may better equip students to provide effective end‑of‑life care in the future.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"93 ","pages":"Article 104842"},"PeriodicalIF":4.0000,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nurse Education in Practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1471595326001447","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/4/24 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

To develop and evaluate a culturally sensitive end-of-life communication course for first-year nursing students, grounded in Kolb’s experiential learning theory.

Background

Global ageing and multimorbidity have intensified the need for effective end-of-life communication, but in China, cultural taboos and limited training hinder its development.

Design

A quasi-experimental, cluster-randomized mixed-methods study was conducted.

Methods

A total of 114 first-year nursing students across four classes were cluster-randomized into an intervention (n = 59; EOLC course) or control group (n = 55; traditional lectures). Pre- and post-tests and between-group comparisons were used to assess learning outcomes. Reflective writings from the intervention group were analysed qualitatively using content analysis.

Results

Post test comparisons showed significant improvements in communication knowledge (MD = 4.36, p = 0.003) and skills (MD = 4.34, p = 0.001). Compared with the control group, the intervention group showed significantly greater improvements in end-of-life care attitudes (β = 7.29, p = 0.028) and positive attitude toward communication skills learning (β = 3.43, p = 0.012). However, the intervention group’s attitude toward caring for the dying person’s family significantly decreased after the program (MD = - 1.19, p < 0.05). Qualitative analysis complemented the quantitative findings, revealing five themes that reflected students’ evolving understanding and professional development.

Conclusions

Within the context of this study, an experiential, culturally tailored end-of-life communication course was associated with enhanced nursing student competencies and attitudes. These findings suggest that introducing such programmes earlier in training may better equip students to provide effective end‑of‑life care in the future.

查看原文本刊更多论文

加强中国一年级护理学生的临终沟通：基于Kolb体验学习理论的文化定制体验课程的混合方法研究。

目的：以科尔布的体验式学习理论为基础，为一年级护理学生开发并评估一门具有文化敏感性的临终沟通课程。背景：全球老龄化和多种疾病加剧了对有效临终沟通的需求，但在中国，文化禁忌和有限的培训阻碍了其发展。设计：采用准实验、集群-随机混合方法进行研究。方法：将114名护理一年级学生分为四个班，随机分组分为干预组（n = 59；EOLC课程）和对照组（n = 55；传统课程）。使用前后测试和组间比较来评估学习效果。使用内容分析对干预组的反思性写作进行定性分析。结果：测试后比较，沟通知识（MD = 4.36, p = 0.003）和技能（MD = 4.34, p = 0.001）有显著提高。干预组患者临终关怀态度（β = 7.29, p = 0.028）和沟通技能学习积极态度（β = 3.43, p = 0.012）较对照组有显著改善。然而，干预组护理临终者家属的态度显著降低（MD = - 1.19, p ）。结论：在本研究的背景下，体验式、文化定制的临终沟通课程与增强护理学生的能力和态度有关。这些发现表明，在培训中更早地引入此类课程可能会使学生更好地掌握将来提供有效的临终关怀的能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Nurse Education in Practice NURSING-

CiteScore

5.40

自引率

9.40%

发文量

180

审稿时长

51 days

期刊介绍： Nurse Education in Practice enables lecturers and practitioners to both share and disseminate evidence that demonstrates the actual practice of education as it is experienced in the realities of their respective work environments. It is supportive of new authors and will be at the forefront in publishing individual and collaborative papers that demonstrate the link between education and practice.