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Advance care planning, Advance directives, Learning activity, Nursing education, Nursing students



  1. Hall, Nancy A. DNP, RN
  2. Grant, Marian DNP, CRNP, ACHPN


Although advance directives can help reduce burden for surrogate decision makers at end of life, completion rates have been disappointingly low since passage of the Patient Self-determination Act. Nurses are uniquely positioned to recommend and assist with advance directive completion, yet they require more education to maximize their impact on advance directive completion. The purpose of this study was to measure the effect of completing one's own advance directive on confidence and actions of students enrolled in registered nurse-bachelor of science in nursing (BSN) completion and prelicensure BSN programs. Twenty-seven registered nurses in a BSN completion program and 34 prelicensure BSN students responded to surveys before and following an assignment that included completing their own advance directives. Significant increases were seen in measures of confidence on the Knowledge, Attitudes, and Experiential Survey on Advance Directives (P = .0074 to P < .0001). Participants reported an increased likelihood of recommending advance directives and improved ability to assist with advance directive completion. The study supports completing one's own advance directive as a potentially effective method to improve nursing students' willingness and ability to recommend and assist with advance directive completion.