Interpretation
The above findings suggest that students did not receive adequate training and education on death and dying before entering their clinical rotations. As mentioned above, this study refuted the hypothesis that a larger percentage of students had received end-of-life training and education before starting clinical rotations. This verifies the need for the university to provide death and dying education for its health science students. The study also confirmed the hypothesis that a larger percentage of students would classify the death and dying education they received as not effective. This strengthens the argument that the university needs to provide advanced educational strategies associated with end-of-life care to improve the overall effectiveness of education.
Comparison with previous studies
Minimal research has been conducted to determine students’ perspectives and coping abilities associated with the death or dying process of patients [
3]. A 2019 study by Cerit [
4] of 81 first-year nursing students examined the impact of training and education centered on the care provided to a dying patient. Pre- and post-tests utilizing the Death Attitude Profile-Revised survey were given to the students to establish their overall attitude and perceptions concerning the care of dying patients. The students were surveyed before death and dying training and then again after the training. The pre-test surveys found that the majority of students expressed genuine fear, anxiety, and incompetence associated with caring for a dying patient [
4]. The post-test results found a significant increase in students’ positive attitudes regarding care for dying patients [
4]. However, the question remains: what strategies and educational methods can be utilized to effectively help students with the death and dying process?
Although no specific technique has demonstrated an absolute ability, there are several methods and strategies to effectively convey the knowledge and skills associated with the death and dying process. Developing the necessary communication skills to provide empathy to those who have lost a loved one can be difficult and takes time to cultivate. Therefore, providing training and education to health science students which combines communication and empathy could be quite beneficial. A study by Hawkins and Tredgett [
5] found that it was beneficial for medical students to participate in high-fidelity simulation exercises to strengthen communication skills when dealing with a patient in cardiac arrest. Students in that study expressed they gained more knowledge and improved their confidence to a greater extent when using the high-fidelity simulations than when using low-fidelity simulations or lecture-based learning methods. Another valuable strategy in assisting health science students to manage the death of patients is the use of the Death Café model forum. Nelson et al. [
6] described the Death Café model as a social setting that simply allowed participants to discuss and engage with each other about the death and dying process. In their study, 24 students from five different health science majors participated in a Death Café event. The participants of that study described the event as valuable and an overall positive experience. The students also expressed that the Death Café experience allowed them to evaluate the death process in a more relaxed and positive environment, which in turn developed a desire “to learn more about issues surrounding death and dying [
6].” In turn, the students expressed a better understanding of the dying process and believed they had gained confidence when asked to discuss and interact with those directly affected by the death and dying experience.
Perez-de la Cruz and Ramirez [
7] discovered the importance of emotional connection and sensitivity training for health science students. In their research of 548 health science students from diverse professional programs, 82.7% of those surveyed understood that the death and dying process would be frequently seen within their profession. However, 40.4% of those surveyed did not feel they were adequately prepared to cope with the emotional and behavioral effects associated with the death and dying process upon entering their field of practice. Those who did feel prepared for delivering end-of-life care reported that learning about the need for compassion and sensitivity to those experiencing death was the most profound training they received [
7]. One aspect that stood out in the study of Perez-de la Cruz and Ramirez [
7] was not the method utilized to teach the students, but more the content that was taught. The researchers found it to be more beneficial to implement training modules that focused on appropriate responses and sensitivity to human suffering than on the technical and scientific aspects of death [
7].
Although effective communication and a proper understanding of the death and dying process are essential for health science students, the ability to cope with the emotions and feelings associated with a dying patient is also crucial. As previously discussed, one of the most significant themes found in the present study was students’ desire to understand strategies used as self-care mechanisms to combat stress and other emotional responses associated with death and dying. According to Forster and Hafiz [
8], several key factors are connected to developing a balanced and effective strategy to cope with the death of patients. These factors include but are not limited to a strong support group of family and friends, spiritual beliefs, acknowledgment of each death versus avoidance, and allowing oneself to experience joy even during difficult times. However, Forster and Hafiz [
8] addressed the fact that not all of the mentioned elements are necessary or required to meet an individual’s self-care needs.
Nia et al. [
9] explained the importance of practicing healthy eating, drinking, sleeping, and exercise habits when grieving the loss of a patient. In many situations involving direct care for dying patients, health care professionals have relied on unhealthy and potentially dangerous habits such as drugs and alcohol to avoid and escape the emotional responses associated with death. However, these activities and behaviors are extremely hazardous and may result in adverse outcomes. Unfortunately, these basic and essential elements of coping with the death and dying process are often never discussed with health science students [
10]. Regardless of the instructional methodology, the introduction and development of death and dying education for health science students must be addressed.
Limitations
Due to the convenience-based selection of students, the surveys were not equally distributed among various groups of healthcare students. This limitation could be addressed by distributing surveys during activities that provide an equal opportunity for all health science students. In addition, the participants of the survey were students from a single university. It would be beneficial to evaluate different strategies and educational objectives from several universities. Future studies conducted at different universities could result in finding students who are well-equipped and prepared for the death and dying process. Evaluating other universities’ methods of delivering death and dying education could also help determine effective teaching strategies to implement in the health science curriculum.
Conclusion
According to the findings of this study, a significant number of students within varied health science fields did not feel that they had received adequate preparation for death and dying at the collegiate level. In an effort to reduce the psychological and behavioral responses associated with the death of patients, it is imperative to provide health science students with the fundamental skills of coping and managing the death and dying process by incorporating timely and effective death and dying classes or training in the curriculum.
By doing so, healthcare students may be better equipped and prepared to care for those in the final stages of life while also maintaining their emotional stability and mindset.