Enhancing End-of-Life Care Competencies of New Graduate Nurses With an Interactive e-Book and Experiential Learning: A Mixed-Methods Study.

Abstract

Background: New graduate nurses often do not have adequate preparation for end-of-life care (EOLC). This study evaluated a blended program integrating an interactive e-book and experiential learning to improve EOLC knowledge, attitudes, learning satisfaction, and reflection.

Method: This mixed-methods study included 65 new graduate nurses from a regional teaching hospital in Taiwan. The intervention comprised e-book self-learning followed by a simulated post-mortem care experiential activity. Quantitative outcomes were measured with structured questionnaires at five assessment points across two instructional phases. Qualitative data were obtained from reflective worksheets completed after experiential sessions (n = 45) to explore learners' experiences and reflection.

Results: Knowledge improved significantly, with greater gains after experiential learning. Attitude changes were modest, although experiential learning produced larger improvements than e-book self-learning and showed short-term effects. Satisfaction was high for both components. Qualitative reflections highlighted perspective-taking, respectful body care, family guidance, and enhanced competence with reduced fear.

Conclusion: The digital-experiential model strengthened the competencies of new graduate nurses in EOLC. Integrating such training into routine in-service education with reinforcement and reflection may support high-quality, dignified EOLC.