Medical Students' Experience of Death and Near-Death of a "Patient" During Simulation: A Qualitative Study

This study explores medical students' perceived learning, emotional responses, and sense of preparedness following simulated death and near-death scenarios to understand how learners interpret these emotionally challenging simulation experiences. Simulation-based medical education empowers students to develop clinical skills in a safe environment, including dealing with critical scenarios involving a patient's death. While these simulations may evoke intense emotional responses, they may also provide thought-provoking learning experiences that promote deeper reflection and introspection.

We adopted an interpretative qualitative approach. Thirteen final-year medical students were recruited using a purposive sampling technique. They were exposed to simulation sessions involving death and near-death using a high-fidelity manikin. A semistructured interview was conducted, and the data were analyzed using thematic analysis. The trustworthiness of the data was ensured through credibility, transferability, dependability, and confirmability criteria.

Five main themes emerged from simulation experiences, i.e emotional responses to simulated death, learning through simulated death, impact on motivation, realism and immersion, and challenges during simulated death. Participants described emotions such as sadness, guilt, and acceptance of death as part of the learning process. Simulation-based learning provided a platform for self-reflection, empathy, safe practice, and preparation for real-life scenarios. Challenges such as limited knowledge and skills, difficulties in leadership and teamwork, and emotional management were identified as subthemes within the challenges theme.

Simulated death may prompt emotional, motivational, and professional reflection among students, while also revealing the need for stronger educational support within simulation-based training. Incorporating structured debriefing and psychological support could help learners better navigate emotionally complex simulation experiences.