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This study supports that a combination of lecture, case-based learning, and simulation with SPs can increase nursing students' cultural competence. With the global aging process intensified, the demand for end-of-life care has surged, especially in China. However, its development is restricted. Understanding the life and death attitude among the elderly and its formation process, and clarifying their needs, are so important to promote social popularization of end-of-life care. This qualitative study included 20 elderly residents in Nan