ORIGINAL RESEARCH article
Front. Educ.
Sec. Higher Education
Volume 10 - 2025 | doi: 10.3389/feduc.2025.1548835
Efficacy of the BOPPPS Teaching Model in Enhancing End-of-Life Care Education and Attitudinal Outcomes Among Chinese Nursing Students
Provisionally accepted
- 1Department of International College of Nursing, Hainan Vocational University of Science and Technology, Haikou, China
- 2Department of intensive care unit, haikou orthopedic and diabetes hospital, Hainan Haikou, China
- 3Haikou City People's Hospital, Xiangya School of Medicine, Central South University, Haikou, Hainan, China
- 4Hainan Women and Children's Medical Center, Haikou, Hainan Province, China
- 5Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan Province, China
- 6The Third Affiliated Hospital of Yunnan University of Chinese Medicine, yunnan, China
- 7Department of Nursing, Shanghai Health and Medical Center, jiangshu, China
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Objective: This 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.Methods: The 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.Results: Both 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.Conclusion: The 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.
Keywords: BOPPPS teaching model, Education, End-of-life care, nursing students, China
Received: 20 Dec 2024; Accepted: 30 Jun 2025.
Copyright: © 2025 Xu, Chen, Xu, Zhang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qiu Zhu Xu, Department of International College of Nursing, Hainan Vocational University of Science and Technology, Haikou, China
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