Active teaching strategies for a sense of salience: End-of-life communication

This study compared active teaching strategies with passive lecture by evaluating cognitive, affective, and psychomotor learning outcomes, while highlighting end-of-life communication in nursing education. The problem addressed was twofold: First, passive lecture prevents transfer to situational decision-making, or a sense of salience (Benner, Sutphen, Leonard, and Day, 2010). Second, death discussions are more complicated than standard communication courses teach. The design was comparative, quasi-experimental, and posttest-only with control. Instruments included a multiple-choice test (Malloy, Virani, Kelly, & Munevar, 2010), a survey measuring openness toward end-of-life communication (Questionnaire for Understanding the Dying Person and His/Her Family , Yeaworth, Kapp, & Winget, 1974), and an observational checklist called the Simulated Client End-of-Life Communication Scale (SCEOLCS). The sample was 46 senior level baccalaureate nursing students enrolled in a private Upper Midwest school of nursing. Significant psychomotor differences were revealed (t(46) = −5.65, p=<.001). No measurable cognitive and affective differences existed. Still, results favored active teaching in all domains. Significant correlation existed between cognitive outcomes and grade point average (r=.338, N=46, p=<.05), and marginal correlation between affective outcomes and GPA (r=−.288, N=46, p=.052). The SCEOLCS demonstrated internal consistency (α=.902). Active teaching strategies improved the nursing student’s sense of salience during end-of-life communication. Ultimately, nursing students were better prepared for one of their most underestimated and rewarding roles, caring for dying patients and their families.