Efficacy of the BOPPPS teaching model in enhancing end-of-life care education and attitudinal outcomes among Chinese nursing students

ObjectiveThis study evaluated the efficacy of the Bridge-in, Objective, Pre-test, Participatory Learning, Post-test, Summary (BOPPPS) teaching model in improving the knowledge, skills, and attitudes of nursing students on end-of-life care.MethodsThe students enrolled in the fourth year of the 2021 n...

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Main Authors: Qiu Zhu Xu, Junxi Chen, Qiusui Xu, Jiali Zhang, Yingzi Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Education
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Online Access:https://www.frontiersin.org/articles/10.3389/feduc.2025.1548835/full
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author Qiu Zhu Xu
Qiu Zhu Xu
Junxi Chen
Qiusui Xu
Jiali Zhang
Yingzi Yang
author_facet Qiu Zhu Xu
Qiu Zhu Xu
Junxi Chen
Qiusui Xu
Jiali Zhang
Yingzi Yang
author_sort Qiu Zhu Xu
collection DOAJ
description ObjectiveThis study evaluated the efficacy of the Bridge-in, Objective, Pre-test, Participatory Learning, Post-test, Summary (BOPPPS) teaching model in improving the knowledge, skills, and attitudes of nursing students on end-of-life care.MethodsThe students enrolled in the fourth year of the 2021 nursing technology program were divided into control (n = 173) and experimental (n = 180) groups. The control group was taught using the traditional method for end-of-life care, and the experimental group was instructed using the BOPPPS method. Standard validated questionnaires, namely Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B) and Templer’s Death Anxiety Scale (T-DAS), were used to measure the attitudes of the students and their emotional responses to end-of-life care following the course. Test–retest was used to assess the reliability of the questionnaires. The academic performance of the students was determined using written and skill-based assessments. Semi-structured interviews were conducted with 12 experimental group participants to obtain qualitative feedback on the BOPPPS instruction. The interviews were audio-recorded, transcribed, and analyzed thematically.ResultsBoth the FATCOD-B (Cronbach’s α = 0.891) and T-DAS (Cronbach’s α = 0.943) had a high internal consistency. Compared to the control group, the experimental group showed significantly higher FATCOD-B scores (89.21 ± 4.96 vs. 87.82 ± 5.29, p < 0.01), T-DAS scores (32.66 ± 9.23 vs. 30.04 ± 9.05, p < 0.01), and total academic scores (90.36 ± 14.45 vs. 81.97 ± 19.77, p < 0.001). The thematic analysis revealed three key benefits of the BOPPPS instruction method: enhanced pre-class engagement, reduced apprehension in terminal care, and improved critical thinking with knowledge internalization.ConclusionThe BOPPPS instructional framework effectively optimizes hospice care education by simultaneously developing nursing students’ knowledge acquisition, clinical skills, and professional attitudes, thereby better preparing them for end-of-life care challenges.
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spelling doaj-art-a42cbb2dfde64d55adf77f0d971e59982025-08-20T04:00:44ZengFrontiers Media S.A.Frontiers in Education2504-284X2025-08-011010.3389/feduc.2025.15488351548835Efficacy of the BOPPPS teaching model in enhancing end-of-life care education and attitudinal outcomes among Chinese nursing studentsQiu Zhu Xu0Qiu Zhu Xu1Junxi Chen2Qiusui Xu3Jiali Zhang4Yingzi Yang5Department of International College of Nursing, Hainan Vocational University of Science and Technology, Haikou, ChinaDepartment of Intensive Care Unit, Haikou Orthopedic and Diabetes Hospital, Haikou, Hainan, ChinaHaikou City People's Hospital, Xiangya School of Medicine, Central South University, Haikou, ChinaHainan Women and Children's Medical Center, Haikou, ChinaKunming Municipal Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan, ChinaDepartment of Nursing, Shanghai Health and Medical Center, Wuxi, ChinaObjectiveThis study evaluated the efficacy of the Bridge-in, Objective, Pre-test, Participatory Learning, Post-test, Summary (BOPPPS) teaching model in improving the knowledge, skills, and attitudes of nursing students on end-of-life care.MethodsThe students enrolled in the fourth year of the 2021 nursing technology program were divided into control (n = 173) and experimental (n = 180) groups. The control group was taught using the traditional method for end-of-life care, and the experimental group was instructed using the BOPPPS method. Standard validated questionnaires, namely Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B) and Templer’s Death Anxiety Scale (T-DAS), were used to measure the attitudes of the students and their emotional responses to end-of-life care following the course. Test–retest was used to assess the reliability of the questionnaires. The academic performance of the students was determined using written and skill-based assessments. Semi-structured interviews were conducted with 12 experimental group participants to obtain qualitative feedback on the BOPPPS instruction. The interviews were audio-recorded, transcribed, and analyzed thematically.ResultsBoth the FATCOD-B (Cronbach’s α = 0.891) and T-DAS (Cronbach’s α = 0.943) had a high internal consistency. Compared to the control group, the experimental group showed significantly higher FATCOD-B scores (89.21 ± 4.96 vs. 87.82 ± 5.29, p < 0.01), T-DAS scores (32.66 ± 9.23 vs. 30.04 ± 9.05, p < 0.01), and total academic scores (90.36 ± 14.45 vs. 81.97 ± 19.77, p < 0.001). The thematic analysis revealed three key benefits of the BOPPPS instruction method: enhanced pre-class engagement, reduced apprehension in terminal care, and improved critical thinking with knowledge internalization.ConclusionThe BOPPPS instructional framework effectively optimizes hospice care education by simultaneously developing nursing students’ knowledge acquisition, clinical skills, and professional attitudes, thereby better preparing them for end-of-life care challenges.https://www.frontiersin.org/articles/10.3389/feduc.2025.1548835/fullBOPPPS teaching modeleducationend-of-life carenursing studentsChina
spellingShingle Qiu Zhu Xu
Qiu Zhu Xu
Junxi Chen
Qiusui Xu
Jiali Zhang
Yingzi Yang
Efficacy of the BOPPPS teaching model in enhancing end-of-life care education and attitudinal outcomes among Chinese nursing students
Frontiers in Education
BOPPPS teaching model
education
end-of-life care
nursing students
China
title Efficacy of the BOPPPS teaching model in enhancing end-of-life care education and attitudinal outcomes among Chinese nursing students
title_full Efficacy of the BOPPPS teaching model in enhancing end-of-life care education and attitudinal outcomes among Chinese nursing students
title_fullStr Efficacy of the BOPPPS teaching model in enhancing end-of-life care education and attitudinal outcomes among Chinese nursing students
title_full_unstemmed Efficacy of the BOPPPS teaching model in enhancing end-of-life care education and attitudinal outcomes among Chinese nursing students
title_short Efficacy of the BOPPPS teaching model in enhancing end-of-life care education and attitudinal outcomes among Chinese nursing students
title_sort efficacy of the boppps teaching model in enhancing end of life care education and attitudinal outcomes among chinese nursing students
topic BOPPPS teaching model
education
end-of-life care
nursing students
China
url https://www.frontiersin.org/articles/10.3389/feduc.2025.1548835/full
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