This study describes the development and implementation of a high-fidelity simulation as the teaching strategy to enhance undergraduate nursing students' satisfaction, self-confidence, knowledge and learning, collaboration, and communication in providing advance care planning to a terminally ill patient. This original simulation was created using the Healthcare Simulation Standards of Best Practice to incorporate the CARES: Competencies And Recommendations for Educating Undergraduate Nursing Students Preparing Nurses to Care for the Seriously Ill and their Families into the nursing curriculum. A descriptive, quantitative study was conducted for 3 years, evaluating feasibility, sustainability, and student outcomes. Student outcomes were measured with the Frommelt Attitude toward the Care of the Dying Scale, the Student Satisfaction and Self-Confidence in Learning Scale, and Educational Practices Questionnaire. The findings showed the average global scores for the Student Satisfaction and Self-Confidence in Learning Scale (n = 174; mean [SD], 4.28 [0.86]) and for the Educational Practices Questionnaire (n = 164; mean [SD], 4.46 [0.7]), and item scores of each scale were heavily skewed toward the maximum score of 5. The high-fidelity simulation for advance care planning was demonstrated to be feasible and sustainable. As an investment in student learning, it increased the students' active learning, collaboration, communication, satisfaction, and self-confidence while learning how to conduct advance care planning for the terminally ill.
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