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Abstract
Background : Communication is essential in palliative care, yet nursing students often struggle in end-of-life (EoL) settings. We evaluated SG-EoL, a gamified simulation to enhance verbal and non-verbal communication. Methods : In a randomized controlled trial (N = 41), SG-EoL was compared with a quiz. Students completed pre/post simulations with a standardized patient; empathetic verbal responses and non-verbal behaviors (nodding, eye gaze, forward leaning) were timed. Results : Forward leaning increased in the intervention group (p =. 02); no significant changes were found for verbal communication, nodding, or eye gaze. Conclusions : SG-EoL improved one non-verbal behavior but not overall communication. Adding feedback, visual cues, and debriefing could enhance learning.