Date of Award

Fall 12-12-2017

Degree Type


Degree Name

Doctor of Nursing Science (DNS)



Committee Chair

Tommie P. Nelms

First Committee Member

Lois R. Robley

Second Committee Member

Linda M. Johnston



Most nursing students fear death or care of the dying and thus question their abilities to give compassionate and competent care to patients or families at end-of-life (EOL). Research has shown positive results when students have experiences with dying patients in environments where interdisciplinary palliative and end-of-life practices are delivered. The purpose of this mixed methods comparative group study was to assess BSN students’ knowledge and attitudes toward care of the dying guided by Bandura’s social cognitive theory, which addresses learning under difficult circumstances. Nursing students in a palliative and end-of-life care elective course were compared to students in the required senior clinical practicum course. In addition to learning about EOL nursing care, students in the elective course were required to spend ten hours “being with” dying patients without providing physical nursing care. Students in the senior practicum course may or may not have had the opportunity to care for dying patients in their 172 hours of clinical. Two instruments were administered before and after the courses: The Palliative Care Quiz for Nurses and the Frommelt Attitude Toward Care of the Dying. Focus groups were also conducted at the end of the courses with both groups of participants. Data were compared, contrasted, and interpreted in consideration of study aims. Participants in the EOL elective gained confidence “being with” dying patients and families. Participants in the practicum course had few experiences with dying patients. Requiring end-of-life content and experiences with dying patients is recommended for all nursing students.