Vicarious learning and communication self-efficacy: A pediatric end-of-life simulation for pre-licensure nursing students

Background: End-of-life clinical experiences, particularly in pediatrics, are quite limited for pre-licensure nursing students. Though effective, end-of-life simulations can be costly, require facilitators trained in palliative and end-of-life care, and are restricted by limited space and time availability. Such barriers prompt the question as to whether there is an effective alternative to simulation by which students can gain improved self-efficacy in therapeutic communication during pediatric end-of-life situations. Purpose: Bandura's Social Cognitive Theory and work exploring self-efficacy posits that vicarious learning provides learners opportunities to gain experience and knowledge through observation of peers in simulated settings. This study evaluated the effectiveness of vicarious versus active learning on pre-licensure nursing students' perceived self-efficacy in providing therapeutic communication during a pediatric end-of-life situation. Method: Data were collected over three time points - pre-simulation, post-simulation, and post-debriefing - using a modified Self-Efficacy in Communication Scale. Results: Learners in both groups had significant improvement in self-efficacy across all time points. Only two items had significant differences between vicarious and active learner groups, but the effect was minor. Conclusion: Vicarious learning presents as a viable pedagogical approach for providing pre-licensure nursing students important learning opportunities related to pediatric end-of-life simulations during both the scenario and debriefing.