Purpose: Preparing a future nurse to respond to the complex and sensitive needs of a child and family during the end-of-life requires more than didactic content in a classroom. During clinical experiences, students may care for children diagnosed with a terminal illness however; it is less likely that a student will have a clinical opportunity to care for a child and their family at the end-of-life. Without having an experience, it is challenging to teach students how to care for the dying child and family including how to appreciate the emotions, thoughts, and expectations when faced with a pediatric death (Lindsay, 2010).

Design And Methods: The instructional model integrates an end-of-life simulation into an undergraduate pediatric nursing course allowing students to practice caring for a child and their family while developing an understanding of the unique needs of a dying pediatric patient.

Results: Post simulation, students participating in guided reflection, identified several themes impacting their experience with end-of-life care, including symptom management, emotional care and "what to say".

Conclusions: The structured simulated experience provided knowledge, skill and awareness to the role of the nurse when providing care at the end-of-life.

Practice Implications: Nurses' behaviors and responses when caring for a child can have a significant impact on the family's experience and memory of their child's death. Unintended actions may result in the family experiencing negative impressions, causing further distress to the grieving family (Butler, Hall, Willetts, & Copnell, 2015).

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