Using high-fidelity simulation to educate nursing students about end-of-life care.

Despite some technical limitations, it is possible to give students a wide range of experiences related to pre- and postmortem care using high-fidelity simulation in a clinical skills lab. Simulations incorporating role play provide important opportunities for students to explore their own ideas about death and caring for patients who are dying. This article reports on the experience of caring for a simulated patient who dies during the scenario and interacting with a family member represented by a standardized actor. Selected educational models are described that provide guidance in developing evidence-based and patient-centered care simulations. A specific, author-developed conceptual model is used to guide development of specific learning activities; the "Silver Hour" represents the 30 minutes prior to the death and immediately following the death. Care of the imminently dying patient, in any setting, can be conceptualized using this model. Specifically, the model encourages students to explore care for the patient as treatment is withdrawn and death is pronounced and to focus on care for families in managing transitions before and after death.