Exploring the application of Heart to Heart Cards in hospice care education for nursing students: a qualitative study

Abstract

Background: Hospice care education is crucial for preparing nursing students to provide holistic end-of-life care. However, traditional pedagogical models often over-rely on one-way knowledge transmission, creating a theory-practice gap and neglecting emotional education. The Heart to Heart Card (HHC), an interactive card-based tool, presents a potential innovative solution. This study qualitatively explored undergraduate nursing students’ experiential perceptions of integrating the HHC into a hospice care course. Methods: A descriptive phenomenological design was employed. Seventeen undergraduate nursing students enrolled in a hospice care elective course were purposively sampled and participated in one-on-one, in-depth, semi-structured interviews between November 2024 and March 2025. Data were analyzed using Colaizzi’s seven-step phenomenological method. Results: Three primary thematic categories emerged from the data analysis: (1) direct impressions and refinement recommendations for HHC within the course, (2) immersive learning and insights from the “Heart to Heart Tea House”, (3) practical challenges in transitioning HHC application from simulations to clinical settings. Conclusion: The HHC serves as an effective pedagogical tool for enhancing hospice care education, as it successfully bridges theory and practice, improving communication skills, and fostering humanistic competencies through its theoretical-practical integration. Further refinements in HHC design and implementation strategies are needed to optimize its applicability across diverse clinical scenarios and cultural contexts.