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Vanitas no Karte

The Case Study of Vanitas

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The Case Study of Vanitas

Episode list

The case study of vanitas.

The Case Study of Vanitas (2021)

S1.E1 ∙ In the Event of Rusty Hopes

The Case Study of Vanitas (2021)

S1.E2 ∙ In the City of Flowers

The Case Study of Vanitas (2021)

S1.E3 ∙ Fangs That Lay Bare Blood

The Case Study of Vanitas (2021)

S1.E4 ∙ Night of Mocking Masks

The Case Study of Vanitas (2021)

S1.E5 ∙ Friends

The Case Study of Vanitas (2021)

S1.E6 ∙ Questions

The Case Study of Vanitas (2021)

S1.E7 ∙ Love

The Case Study of Vanitas (2021)

S1.E8 ∙ Where Death Slumbers

The Case Study of Vanitas (2021)

S1.E9 ∙ Those Who Hunt Crimson

The Case Study of Vanitas (2021)

S1.E10 ∙ No. 69

The Case Study of Vanitas (2021)

S1.E11 ∙ Promise

The Case Study of Vanitas (2021)

S1.E12 ∙ Point of Departure

The Case Study of Vanitas (2021)

S1.E13 ∙ A Chance Encounter

The Case Study of Vanitas (2021)

S1.E14 ∙ The Witch and the Young Man

The Case Study of Vanitas (2021)

S1.E15 ∙ The d'Apchiers' Vampire

The Case Study of Vanitas (2021)

S1.E16 ∙ The Beast

The Case Study of Vanitas (2021)

S1.E17 ∙ Hands Upon a Nightmare

The Case Study of Vanitas (2021)

S1.E18 ∙ Just the Two of Us

The Case Study of Vanitas (2021)

S1.E19 ∙ Snow Flower

The Case Study of Vanitas (2021)

S1.E20 ∙ The Incurable Disease

The Case Study of Vanitas (2021)

S1.E21 ∙ Scars

The Case Study of Vanitas (2021)

S1.E22 ∙ Blue Night

The Case Study of Vanitas (2021)

S1.E23 ∙ Tears like Rain

The Case Study of Vanitas (2021)

S1.E24 ∙ His Wish

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Season 1 – The Case Study of Vanitas

Where to watch, the case study of vanitas — season 1.

Watch The Case Study of Vanitas — Season 1 with a subscription on Hulu, or buy it on Prime Video.

Audience Reviews

Cast & crew.

Zeno Robinson

Molly Searcy

Arisa Kiyoto

Natsumi Fujiwara

Fairytale Vanitas

Ryosuke Hara

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Season Info

The Case Study of Vanitas Episode 24 - A Profoundly Momentous Finale

Featured Image: The Case Study of Vanitas Episode 24 - A Profoundly Momentous Finale

The Case Study of Vanitas episode 24 wraps up with quite an emotional and action-packed finale! If it’s one thing we’ve come to learn throughout the season, it’s that Vanitas is a difficult and complicated character to understand. At the same time though, he is also just as compelling. These last developments in the story have made him more human than ever, making this finale very momentous.

It’s not just Vanitas – the friendship he’s grown to have with Noé is also finally acknowledged and appreciated. All in all, the finale achieves in delivering a perfectly constructed episode and an even more powerful conclusion to the show. I personally think it was awesome, and it hit right in the feels . 

Why Vanitas Couldn’t Kill Noé

The Case Study of Vanitas episode 24

“Why..? Why can’t I kill you?”

The past season has been an emotional roller coaster ride, right? This arc has particularly highlighted Noé and Vanitas’ friendship, which is why the cliffhanger last week was super frustrating! To summarize, freedom for Vanitas meant that he’d be alone in his anguish. He is always guarded and distant so he wouldn’t have friends “to lose.” The situation Mikhail had them in was really difficult. However, I think we can all agree at this point that Noé is not a stranger — they’ve already grown together as companions and friends. So as complicated and as simple as it is, that is why Vanitas couldn’t kill Noé.

Strength Within Dominique de Sade

The Case Study of Vanitas episode 24 - Dominique de Sade

“In the name of protection, let us take up our swords together.”

In the end, it wasn’t Noé who saved Dominique — it was the other way around, she saved them! Domi breaks free from her grayscale mental prison and creates a beautiful rain of ice attacks which stops Mikhail’s rampage over the carnival. It was badass, but the one I really love is how she survived her internal struggle. Louis, or at least the version of her as Louis, is the one that tells her — “Mikhail just used that book to hit you where are most fragile and vulnerable. He didn’t even put a scratch on our true name.”

She realizes that she’s stronger than she thinks and that she has to confront and accept her inner “selves”. It was a true moment of courage, one that shows Domi’s true character and strength. She deserves happiness, and with the company of good friends ( like Jeanne in the cafe), she can finally grieve and move forward. My heart is full for her.

The Mastermind Behind the Nightmare

Whenever a finale comes around, the absence of the opening theme really adds that excitement! The Case Study of Vanitas episode 24 did an absolutely amazing job in making those first minutes an emotional and epic one. From the aftermath of Vanitas and Noé’s fight, their silent breakdowns,  Mikhail’s violent outburst, Domi’s ice creations, – and the most twisted and shocking of all – the reveal of the involvement of Noé’s teacher, the former Marquis de Sade.

Former Marquis de Sade

“The World of Dreams has crumbled to ruins. Whether they be the sweet dreams that soothe us in the cradle or the nightmares that eat away at our hearts, dreams are still dreams in the end. There will always come a time when we must open our eyes and face reality. That is when we shall meet again, my darling kitten. “

The Shapeless One, just like his name, is super creepy and chilling. (Voiced by Akira Ishida). His sudden appearance here makes things shadier, even with Charlatan and Ruthven’s separate movements. There are so many questions, but the most off-putting thing here is the fact that his eyes — a unique pair of pink and blue — are similar to a certain cat we know of. The transition with that blue cat couldn’t be any more obvious. It might even be possible that a part of his plan was to have Noé seek out the Book of Vanitas in the first place.

Vanitas, the Blue Moon Vampire’s Kin

Personally, I think the rooftop scene is the best part of the episode. It is melancholic, but it makes me feel both happy and sad at the same time. You see, The Case Study of Vanitas episode 24 is titled, “ Apres la pluie – His Wish. ” At first, I thought it was in homage to Luna, the Vampire of the Blue Moon. Turns out it’s not — it’s also about Vanitas’ request of Noé. We already know most of Vanitas’ mysterious past from Mikhail and it’s true — the Book will rewrite them sooner or later. Noé actually mentioned this back in the first episode, and given the trust, understanding, and respect they’ve developed in these recent events — it makes it all the more bittersweet. When Noé started tearing up, I definitely felt that.

The Case Study of Vanitas episode 24 - Vanitas' Wish

The Case Study of Vanitas episode 24 resolves a lot of things, including Luna’s fate and the full meaning behind Vanitas’ mission to cure vampires. He calls it vengeance, but it does come from a good place in his heart. That’s why it breaks me to see what has become of Mikhail, and I’m not gonna lie — the sudden change from his weeping to his emotionless face was so creepy. Oh the poor boy, at least he shows some kindness towards Domi in the end.

I love that the rooftop scene also has this calm and hopeful air in the end. Now, Vanitas can move on forward with a less heavy heart. The finale is reminiscent of episode 19 when Luna tells Vanitas “not to shut your heart away.” The fact that the hourglass earring is constantly focused on and that Vanitas in the ending theme doesn’t look back makes me all the more emotional.

A Great Finale for a Great Series

I absolutely loved this show, from start to finish. Even though the last arc has been a terrifying, heart-wrenching, and emotionally-damaging watching experience! The writing is wonderful — the way the stories and personalities unravel has a lot of depth in it. It is very moving, especially because I always love a good character development. It is very profound, and I couldn’t ask for a better finale.

Vanitas, Luna, and Mikhail

The Case Study of Vanitas shines best with its steam-punk aesthetics, amazing lore, stunning visuals and animation, and my personal favorite, the beautiful soundtrack. Vanitas and Noé, including their voice actors, have been quite the interesting pair to watch on their adventures, which is also one of the best appeals of the show! Aside from the comedy, the touch of drama (and erotic energies) is what makes this show stand out from the others. I personally had a lot of fun watching it, and I guess we have Studio Bones to thank for this wonderful adaptation. 

If you didn’t know, the anime has already caught up with the original material. This means that there is nothing to dive into right now or for quite a time soon. (Which honestly, makes me very sad.) Nevertheless, it has been a great ride and I am eagerly looking forward to what they have in store next. You can also check out Jun Mochizuki’s special illustration of her celebration of the last episode. See the tweet below: 

アニメ『ヴァニタスの手記』、本当に本当に本当に本当に!本当に!!ありがとうございました!! これからご覧になる方は引き続きよろしくお願いいたします! pic.twitter.com/g5zMajZMPn — 望月淳@ヴァニタスの手記📘アニメ第2クール絶賛放送中❗️🎉 (@jun_mdesu) April 1, 2022

The Case Study of Vanitas is available to watch on Crunchyroll, Funimation, and Bilibil in select regions. Make sure to visit their official website and Twitter for merchandise updates! Don’t forget to vote for your favorite characters and voice actors in our polls . Ciao!

Images via Bilibili ©Jun Mochizuki/SQUARE ENIX, “Vanitas no Carte” Production Committee

teacher the case study of vanitas

Carla Carreon

Hello, I'm Carla Bianca! Just a fluffy bean with introverted energies. Reading, watching, drawing, playing Genshin, and sleeping mostly take up my day. Someday, I will have my manga library and Rimuru shrine!

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The Case Study Of Vanitas - What We Know So Far

Noé Archiviste looking surprised

Avid manga readers have probably picked up, or at least heard of, "The Case Study of Vanitas." Set in 19th century Paris, the story's use of steampunk has produced gorgeous and unique art that puts one in mind of the ever-popular "Black Butler." However, the aesthetic isn't the only thing that makes this story interesting. Created by Jun Mochizuki ("Pandora Heart"), "Case Study" follows Noé Archiviste as he aids Vanitas on his journey to help vampires from giving into their predatory nature. It is not an easy task though, as danger lurks in every corner and a force called the Charlatan tries to corrupt the vampires before they can be saved. The series has appeared in Square Enix's "Monthly Gangan Joker" since 2015, and has since produced 8 volumes. 

Fans of "Case Study" will be pleased to know that Vanitas and Noé will be animated. The anime will be adapted by Bones Inc. Studio, which is known for producing popular series such as " Fullmetal Alchemist: Brotherhood ," "Ouran High School Host Club" and, most recently, "My Hero Academia." Here is everything we know about "The Case Study of Vanitas." 

When will The Case Study of Vanitas be released?

According to Anime News Network , Aniplex revealed back in March that the anime adaptation of "The Case Study of Vanitas" was on its way. It was later announced that the series would premiere on July 2nd and will air across multiple TV networks (via  Crunchyroll ). In addition to Bones Inc., Tomoyuki Itamura of "Owarimonogatari" will be directing, while Deko Akao of "Snow White with the Red Hair" and Yoshiyuki Ito of "Carole & Tuesday" will be serving as the script overseer and the character designer, respectively.

The anime's official Twitter also recently attached a trailer , which features Vanita's book of healing, fights with vicious vampires , and of course, the stunning 19th century Paris in which all the action takes place. Fan reaction to the over minute-long teaser was overwhelming, with many merely responding with heart-eyes emojis and gifs to accurately express their excitement. 

With only a couple of weeks to go, viewers won't have to wait long to return to Vanita's world or venture into it for the very first time. 

What characters will be in the "The Case Study of Vanitas?"

"The Case Study of Vanitas" features a wide variety of characters, who add more to both the plot and various relationships. If the anime will cover the first 40 or so chapters, fans can expect many of these people to make an appearance. 

Vanitas is the current holder of the Book of Vanitas, and thanks to its powers, he can do amazing things, though he claims to be a normal human. Despite his seemingly carefree personality, Vanitas' childhood — his parents were murdered by a vampire and his guardian subjected him to painful tests — has shaped who he is and what he does. During his travels, he meets Noé Archiviste, a man seeking the Book under the orders of his teacher. Noé is very caring, and because of this, he travels with Vanitas, finding his mission to save vampires rather than kill them to be an honorable deed. 

On Noé's and Vanitas' journeys, they come across other friends and enemies. These include Jeanne, an enslaved vampire ordered to kill her own kind; Luca, a young vampire and son of the Grand Duke; Dominique, Noé's childhood friend who harbors unrequited feelings for him, and the Teacher, a cruel, mysterious, and ancient vampire that exploits his students. 

The series is also likely to expand on supporting characters responsible for leading the main cast into even more perilous situations. 

What will be the plot of "The Case Study of Vanitas?"

Noé Archiviste hopes to find the legendary Book of Vanitas, a relic with extraordinary powers. Aboard a 19th century blimp, he meets Vanitas, the newest inheritor of the ancient text. Together, they search for sick vampires and use the power of the book to heal them. 

Most animes' first seasons usually follow up to the manga's  sixth or seventh volume, so we can expect this series to do the same. Within those approximately 40 chapters, the adaptation will depict Noé's first meeting with Vanitas, how Vanitas utilizes the book to get the job done, the introductions of Luca, Jeanne, and Dominique, Noé's relationship with the mysterious Teacher, and the risks of dealing with bloodsuckers and the Charlatan that threatens to undo Vanitas' work and continue to corrupt any vampires. 

Though there are more than seven volumes currently published, fans will have to wait for the "Case Study of Vanitas" to get renewed if they want to see the next adventure animated.

teacher the case study of vanitas

Strongest Characters in The Case Study of Vanitas: Vanitas, Noe, & More

T he Case Study of Vanitas is a story based in a fictional 19th-century Paris where humans and vampires share the city. The story revolves around Vanitas and his companion, Noe Archiviste. They are on a quest to heal cursed vampires through the Book of Vanitas. It goes into detail about the Vampire born under the Blue Moon. He was isolated because of their fear, and thus, he swore vengeance against the vampires born under the Red Moon. His name was none other than Vanitas. The narrative is a memoir from the eyes of Noe Archiviste. He delves into how he came to meet Vanitas, their journey together, and how it eventually ends.  

Vanitas 

While he derives his name from an old vampire and uses his grimoire The Book of Vanitas. One wouldn't be harshly criticized if they had mistaken Vanitas for a vampire. And that speaks for Vanitas himself, who is a human first and foremost. While he isn't physically weak, he compensates for his lack of strength with his intelligence and grimoire. A combination of these two allows him to manipulate the actual names of vampires, making him a formidable presence within the series.

Noe Archiviste 

The sole survivor of the Archiviste clan, Noe is the narrator of the series and accompanies Vanitas on his journey of curing Vampires. While one may argue that Noe has been defeated several times within the series. It might be accurate, but his compassion and kindness prevent him from having a severe physical altercation.

Despite being a vampire himself, Noe treats vampires and humans as equally good creatures. It’s this good virtue that pulls him down from time to time. But make no mistake, with his ability to relive memories just by drinking the respective person's blood. It is safe to say one wouldn't want to get on his wrong side.

Lucius Oriflamme

He is one of the most powerful and influential characters in The Case Study of Vanitas. Despite his young age, he serves as the Grand Duke to the Vampire Queen herself. He's an aristocrat through and through.

Despite his childlike demeanor, he's quite skilled at manipulating others with his strategic ploys and engagement in political scenarios to further his motive and maintain his clan's position of power. To top it off, he holds Jeanne as his Chevalier.

Prolific, Revered, and the guardian of Lucius Oriflamme, Ruthven is often considered one of the most essential characters in The Case Study of Vanitas. Playing a pivotal role in ending the war between humans and vampires, he now finds himself as a member of the Senate and is well-known amongst humans as well.

He sought peace between humans and vampires during the war, even acting as a peacemaker. Having been betrayed by his students, he no longer shares the same passion and is ready to use any means to seek his desires. Cold, ruthless, and feared by vampire society, with his powers yet to be showcased, he's just a testament to the man that is Ruthven.

Jean-Jacques Chastel

Chastel is the protector and longtime companion of Chloe d'Apchier and the last surviving member of the d'Apchiers. His loyalty knows no bounds, as he goes on to sign a contract with the devil itself just to realize Chloe's wish. He turns himself into the very beast the village feared in exchange for his actual name. He wreaks havoc on anyone who tries to hurt Chloe, a symbol of his genuine and sincere feelings towards her.

The post Strongest Characters in The Case Study of Vanitas: Vanitas, Noe, & More appeared first on ComingSoon.net - Movie Trailers, TV & Streaming News, and More .

Strongest Characters in The Case Study of Vanitas: Vanitas, Noe, & More

BRIEF RESEARCH REPORT article

This article is part of the research topic.

Impact of COVID-19 Pandemics and Syndemics on Healthcare Systems Worldwide

Teachers as caregivers of grieving children in school in the post-Covid-19 era: Using the Self-Determination Theory to conceptualize teachers' needs when supporting grieving children's mental health Provisionally Accepted

  • 1 Achva Academic College, Israel

The final, formatted version of the article will be published soon.

It has been estimated in recent studies that more than 1.5 million children worldwide lost a caregiver due to the COVID-19 pandemic. Childhood bereavement is associated with heightened risks of impaired academic and social performance, mental health issues, substance use disorders, and higher mortality rates. Yet children may receive insufficient support post-loss. Although the role of school psychologists in supporting grieving students has been examined, little is known about the role of teachers in this context. Specifically, knowledge about teachers' needs when supporting bereaved children is lacking.The study's aim was to explore teachers' needs, drawing upon a well-established framework -selfdetermination theory (SDT) -which focuses on three human needs considered essential for optimal functioning: autonomy, competence, and relatedness. Methods Employing a qualitative approach, 36 teachers were interviewed about their needs when supporting grieving students. Interviews were transcribed and then analyzed using thematic content analysis.Analysis revealed three SDT-related needs: knowledge (theory-and practice-related), acknowledgment, and support (emotional and practical).The findings enhance our theoretical understanding of childhood bereavement and may promote policy changes that ensure teachers' needs satisfaction. Its significance lies in the basic premise that supporting teachers' needs in the context of pediatric grief may eventually lead to their optimal ability to enact best practices for supporting grieving students' well-being.

Keywords: self-determination theory, Childhood grief, Teachers as caregivers, Post-COVID-19, qualitative case study research

Received: 11 Oct 2023; Accepted: 16 May 2024.

Copyright: © 2024 Frei-Landau. 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: Dr. Rivi Frei-Landau, Achva Academic College, Arugot, Israel

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WEATHER ALERT

3 advisories in effect for 14 regions in the area

How to teach your kids body boundaries, consent to keep them safer throughout their lives, a tough topic, but starting age-appropriate lessons very young decreases chances of child abuse, research shows.

Courtney Friedman , Anchor/Reporter

Robert Samarron , Photojournalist

Ken Huizar , Photojournalist

SAN ANTONIO - – These days you hear the word ‘boundaries’ a lot when talking about well-being.

What does that mean?

Boundaries are rules or expectations you put in place that make you feel safe, respected or free to be yourself.

One type of boundary is consent, the ability and right to decide who is allowed in your personal space.

Parents and experts say it’s important to teach kids these concepts as early as possible, so they are less likely to be taken advantage of, either in relationships or by perpetrators.

This topic can be a difficult and uncomfortable thing to think about, but many people believe this is a major key to forming a future generation that is more confident, secure and free from abuse.

‘We’re teaching them how to be safe’

San Antonio mom Kati Zech embraces the love and chaos of motherhood, with a 4-year-old, 2-year-old and another due in the fall.

“I can lose sleep over thinking about safety and making sure we’re teaching them how to be safe,” Zech said.

That’s why she and her husband Jordan make time daily, to teach their little ones about physical boundaries.

It’s not an easy task with toddlers.

“My oldest son has a lot of energy and he is going to be more aggressive, playfully. And so we’re really trying to teach him to respect other people’s bodies. He’s okay if you want to come up and wrestle with him, but not every kid’s like that,” Zech said.

Her hope is that these teachings will allow him to also form his own boundaries.

“Then he’ll know if he doesn’t like something, he’s allowed to also say, ‘Hey, I don’t like that. Don’t do that,’” Zech said.

Those lessons come with simple yet specific body awareness.

“It’s even teaching them, ‘This is your body and these are the parts of your body that are just for you. Nobody else is going to touch them,’” she said.

Zech knows these concepts are worth teaching, because they will lead her kids to healthy relationships.

‘You can never read someone else’s mind’

That thought process is echoed by Dr. Jennifer Gunsaulus . She’s a sociologist, intimacy speaker, relationship coach, author, and survivor.

“There’s that basic body autonomy and body respect in others. It’s so simple and so profound,” Gunsaulus said.

Animated and passionate, Gunsaulus focuses most on young adults and safe dating relationships.

“Talking to your teenagers about, ‘You can never read someone else’s mind. You can never assume what someone else wants or likes,’” she said.

Gunsaulus understands the things she’s teaching at a very personal level.

“I experienced situations and sexual contacts where I was feeling pushed and pushed and I said ‘I don’t want to do that’ and I was pushed and I said, ‘Alright I guess we’re doing this,’” she said.

At the time, she had a foundation built on boundaries, so she was able to understand that those boundaries had been violated.

“I knew I didn’t do anything wrong. I know I had clearly communicated that. Held him responsible and said, ‘what was that?’” she said.

Gunsaulus said that preparation and self-confidence can eliminate shame, which often festers into silence and a possible lifetime of trauma.

“When you set that up from a young age of being like, ‘No if anyone else does this, they are the bad one, not you.’ You don’t end up taking on that shame,” Gunsaulus explained.

Gunsaulus wants other young adults to have those skills too, with age-appropriate lessons.

“You start that at a young age, it is so normal to them that no one touches them without their agreement, and if someone does, they know it’s wrong and then they go talk to someone about it. That’s just their normal way of viewing the world and then they also know, ‘I don’t do that to anyone else,’” she said.

There are fun and easy metaphors she offers parents who are teaching young kids.

“I say, ‘Think about cats.’ Cats are really good about teaching consent. Dogs, not so much, because you can touch and they’ll take anything. But cats, they’ll let you know. They put up their boundaries. I remember a while ago our friend’s son was like, ‘Fluffy scratched me’ and they said ‘Well, what were you doing?’ ‘Petting fluffy’ ‘Did fluffy want to be pet?’ ‘No,’” Gunsaulus chuckled.

‘Embrace the awkward’

She coaches young adults on what to say when laying down their boundaries.

“Embrace the awkward! I can’t emphasize this enough. To put up a boundary is to say something like, ‘Oh no I don’t feel comfortable doing that because I want to enjoy this situation. I want to enjoy you, I want to be with you, and I want to feel comfortable,’” she said.

Embracing the awkward also goes for parents and caregivers trying to make sure older kids know how to be respected physically.

“Anything you’re afraid to talk about, say that. ‘I feel awkward doing this. I feel vulnerable. My parents didn’t do this for me but I love you so much, I want to do things differently,” Gunsaulus said.

That honesty creates confidence they can rely on when they go out into the world.

“They’re at a party, they’re in high school, they’re in college, they’re off on their own. You’ve taught them the skills of how to reflect on something in a situation, how to handle difficult things so they can make the healthiest choices for them,” Gunsaulus said.

Without these tools, kids can end up in some scary situations.

‘How can we prevent it if we’re not addressing it’

Now here’s the part when we talk about a subject that feels icky: child sexual abuse.

As uncomfortable as this topic is, society has to start talking about it, because that’s the first step to stopping it.

“How can we even prevent it if we’re not addressing it?,” said Randy McGibeny, the president and CEO of ChildSafe.

ChildSafe is a nationally recognized organization in San Antonio, that offers support to children who have been abused or traumatized.

McGibeny said getting into that uncomfortable space as adults could actually cause systematic solutions for our future generations.

“If we don’t address the issue and we’re not honest about saying words like child sexual abuse, we’re not normalizing the issue. We create a safer environment for children to feel like maybe they can come forward, that ‘I am going to be listened to, that I am going to be believed,’” McGibeny explained.

He said perpetrators prevail by silencing victims, so our voices are what will stop their crimes.

It all starts with prevention and the role parents or caregivers can play, starting when our kids are young.

“The evidence and the research shows that the earlier you start to have these conversations with young children, the better outcome it has for preventing child abuse,” McGibeny said.

Those age-appropriate lessons include learning the anatomical names of body parts, instead of using nicknames. That reduces body shame and allows kids to be very specific if they have to explain that someone violated them.

Other safety lessons mean breaking habits many people grew up with.

“We would leave my grandmother’s house and my parents would be like, ‘Oh, go give your grandmother a kiss or go give them a kiss’. That’s not necessarily a safe thing. It teaches children that they don’t have control over their bodies. And so what am I telling you? That I’m forcing you to go and hug or touch somebody, that maybe you don’t feel comfortable hugging or touching?” McGibeny said.

If kids clearly don’t want to give hugs and kisses, maybe ask them if they want a fist-bump or a wave instead. He said, give them a choice, and they’ll remember that.

“We’re not saying the way you grew up is wrong. It’s just we know better now about how to keep our kids safe. We know just through research,” he said.

That research has allowed ChildSafe to find solutions when it comes to prevention.

“We have a primary preventative program here at Child Safe, where we do go into the community and we will work with children around having those conversations. We will work with adults and teach adults how to have those conversations,” McGibeny said.

If you can’t make it in person, all you have to do is jump online.

“This is a live webinar,” McGibeny said showing the website. “So you’re going to actually be able to engage with our staff ask questions do those types of things. Oftentimes we’ll put a report a recorded webinar online as well.”

He also needs families to know, if abuse does happen, ChildSafe has so many resources.

Walking through the halls of ChildSafe, McGibeny said, “Every one of these are therapeutic offices here. We have about 16 full-time therapists.”

It’s a strong team that works to change the trajectory of children’s lives by treating trauma, as well as helping prevent it.

The entire goal is to promote healthy, beautiful relationships sooner than later.

“This will affect their careers. It’ll affect so many different parts of their life, if they can learn how to have boundaries for themselves and have boundaries with other people, then they’re going to succeed in a lot of different ways,” Zech said.

She feels better as a parent knowing she’s consistently doing all she can to prepare them for life’s experiences.

That’s all any parent can ask for: kids who grow up understanding themselves, respecting others, and being able to love safely and fully.

If you or a loved one is a sexual assault survivor, reach out now. Whether the abuse happened recently or years ago, help is waiting.

You can contact ChildSafe at (210) 675-9000 , the Rape Crisis Center at (210) 349-7273 , or call the national helpline at 800-656-HOPE (4673) .

Your strength in reporting can change the future for so many others.

Copyright 2024 by KSAT - All rights reserved.

About the Authors

Courtney friedman.

Courtney Friedman anchors KSAT’s weekend evening shows and reports during the week. Her ongoing Loving in Fear series confronts Bexar County’s domestic violence epidemic. She joined KSAT in 2014 and is proud to call the SA and South Texas community home. She came to San Antonio from KYTX CBS 19 in Tyler, where she also anchored & reported.

Robert Samarron

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  • Open access
  • Published: 14 May 2024

Developing a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in Medical Assistance in Dying (MAiD): a mixed method modified e-Delphi study

  • Jocelyn Schroeder 1 ,
  • Barbara Pesut 1 , 2 ,
  • Lise Olsen 2 ,
  • Nelly D. Oelke 2 &
  • Helen Sharp 2  

BMC Nursing volume  23 , Article number:  326 ( 2024 ) Cite this article

31 Accesses

Metrics details

Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. Canada’s legislation is the first to permit Nurse Practitioners (NP) to serve as independent MAiD assessors and providers. Registered Nurses’ (RN) also have important roles in MAiD that include MAiD care coordination; client and family teaching and support, MAiD procedural quality; healthcare provider and public education; and bereavement care for family. Nurses have a right under the law to conscientious objection to participating in MAiD. Therefore, it is essential to prepare nurses in their entry-level education for the practice implications and moral complexities inherent in this practice. Knowing what nursing students think about MAiD is a critical first step. Therefore, the purpose of this study was to develop a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in MAiD in the Canadian context.

The design was a mixed-method, modified e-Delphi method that entailed item generation from the literature, item refinement through a 2 round survey of an expert faculty panel, and item validation through a cognitive focus group interview with nursing students. The settings were a University located in an urban area and a College located in a rural area in Western Canada.

During phase 1, a 56-item survey was developed from existing literature that included demographic items and items designed to measure experience with death and dying (including MAiD), education and preparation, attitudes and beliefs, influences on those beliefs, and anticipated future involvement. During phase 2, an expert faculty panel reviewed, modified, and prioritized the items yielding 51 items. During phase 3, a sample of nursing students further evaluated and modified the language in the survey to aid readability and comprehension. The final survey consists of 45 items including 4 case studies.

Systematic evaluation of knowledge-to-date coupled with stakeholder perspectives supports robust survey design. This study yielded a survey to assess nursing students’ attitudes toward MAiD in a Canadian context.

The survey is appropriate for use in education and research to measure knowledge and attitudes about MAiD among nurse trainees and can be a helpful step in preparing nursing students for entry-level practice.

Peer Review reports

Medical Assistance in Dying (MAiD) is permitted under an amendment to Canada’s Criminal Code which was passed in 2016 [ 1 ]. MAiD is defined in the legislation as both self-administered and clinician-administered medication for the purpose of causing death. In the 2016 Bill C-14 legislation one of the eligibility criteria was that an applicant for MAiD must have a reasonably foreseeable natural death although this term was not defined. It was left to the clinical judgement of MAiD assessors and providers to determine the time frame that constitutes reasonably foreseeable [ 2 ]. However, in 2021 under Bill C-7, the eligibility criteria for MAiD were changed to allow individuals with irreversible medical conditions, declining health, and suffering, but whose natural death was not reasonably foreseeable, to receive MAiD [ 3 ]. This population of MAiD applicants are referred to as Track 2 MAiD (those whose natural death is foreseeable are referred to as Track 1). Track 2 applicants are subject to additional safeguards under the 2021 C-7 legislation.

Three additional proposed changes to the legislation have been extensively studied by Canadian Expert Panels (Council of Canadian Academics [CCA]) [ 4 , 5 , 6 ] First, under the legislation that defines Track 2, individuals with mental disease as their sole underlying medical condition may apply for MAiD, but implementation of this practice is embargoed until March 2027 [ 4 ]. Second, there is consideration of allowing MAiD to be implemented through advanced consent. This would make it possible for persons living with dementia to receive MAID after they have lost the capacity to consent to the procedure [ 5 ]. Third, there is consideration of extending MAiD to mature minors. A mature minor is defined as “a person under the age of majority…and who has the capacity to understand and appreciate the nature and consequences of a decision” ([ 6 ] p. 5). In summary, since the legalization of MAiD in 2016 the eligibility criteria and safeguards have evolved significantly with consequent implications for nurses and nursing care. Further, the number of Canadians who access MAiD shows steady increases since 2016 [ 7 ] and it is expected that these increases will continue in the foreseeable future.

Nurses have been integral to MAiD care in the Canadian context. While other countries such as Belgium and the Netherlands also permit euthanasia, Canada is the first country to allow Nurse Practitioners (Registered Nurses with additional preparation typically achieved at the graduate level) to act independently as assessors and providers of MAiD [ 1 ]. Although the role of Registered Nurses (RNs) in MAiD is not defined in federal legislation, it has been addressed at the provincial/territorial-level with variability in scope of practice by region [ 8 , 9 ]. For example, there are differences with respect to the obligation of the nurse to provide information to patients about MAiD, and to the degree that nurses are expected to ensure that patient eligibility criteria and safeguards are met prior to their participation [ 10 ]. Studies conducted in the Canadian context indicate that RNs perform essential roles in MAiD care coordination; client and family teaching and support; MAiD procedural quality; healthcare provider and public education; and bereavement care for family [ 9 , 11 ]. Nurse practitioners and RNs are integral to a robust MAiD care system in Canada and hence need to be well-prepared for their role [ 12 ].

Previous studies have found that end of life care, and MAiD specifically, raise complex moral and ethical issues for nurses [ 13 , 14 , 15 , 16 ]. The knowledge, attitudes, and beliefs of nurses are important across practice settings because nurses have consistent, ongoing, and direct contact with patients who experience chronic or life-limiting health conditions. Canadian studies exploring nurses’ moral and ethical decision-making in relation to MAiD reveal that although some nurses are clear in their support for, or opposition to, MAiD, others are unclear on what they believe to be good and right [ 14 ]. Empirical findings suggest that nurses go through a period of moral sense-making that is often informed by their family, peers, and initial experiences with MAID [ 17 , 18 ]. Canadian legislation and policy specifies that nurses are not required to participate in MAiD and may recuse themselves as conscientious objectors with appropriate steps to ensure ongoing and safe care of patients [ 1 , 19 ]. However, with so many nurses having to reflect on and make sense of their moral position, it is essential that they are given adequate time and preparation to make an informed and thoughtful decision before they participate in a MAID death [ 20 , 21 ].

It is well established that nursing students receive inconsistent exposure to end of life care issues [ 22 ] and little or no training related to MAiD [ 23 ]. Without such education and reflection time in pre-entry nursing preparation, nurses are at significant risk for moral harm. An important first step in providing this preparation is to be able to assess the knowledge, values, and beliefs of nursing students regarding MAID and end of life care. As demand for MAiD increases along with the complexities of MAiD, it is critical to understand the knowledge, attitudes, and likelihood of engagement with MAiD among nursing students as a baseline upon which to build curriculum and as a means to track these variables over time.

Aim, design, and setting

The aim of this study was to develop a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in MAiD in the Canadian context. We sought to explore both their willingness to be involved in the registered nursing role and in the nurse practitioner role should they chose to prepare themselves to that level of education. The design was a mixed-method, modified e-Delphi method that entailed item generation, item refinement through an expert faculty panel [ 24 , 25 , 26 ], and initial item validation through a cognitive focus group interview with nursing students [ 27 ]. The settings were a University located in an urban area and a College located in a rural area in Western Canada.

Participants

A panel of 10 faculty from the two nursing education programs were recruited for Phase 2 of the e-Delphi. To be included, faculty were required to have a minimum of three years of experience in nurse education, be employed as nursing faculty, and self-identify as having experience with MAiD. A convenience sample of 5 fourth-year nursing students were recruited to participate in Phase 3. Students had to be in good standing in the nursing program and be willing to share their experiences of the survey in an online group interview format.

The modified e-Delphi was conducted in 3 phases: Phase 1 entailed item generation through literature and existing survey review. Phase 2 entailed item refinement through a faculty expert panel review with focus on content validity, prioritization, and revision of item wording [ 25 ]. Phase 3 entailed an assessment of face validity through focus group-based cognitive interview with nursing students.

Phase I. Item generation through literature review

The goal of phase 1 was to develop a bank of survey items that would represent the variables of interest and which could be provided to expert faculty in Phase 2. Initial survey items were generated through a literature review of similar surveys designed to assess knowledge and attitudes toward MAiD/euthanasia in healthcare providers; Canadian empirical studies on nurses’ roles and/or experiences with MAiD; and legislative and expert panel documents that outlined proposed changes to the legislative eligibility criteria and safeguards. The literature review was conducted in three online databases: CINAHL, PsycINFO, and Medline. Key words for the search included nurses , nursing students , medical students , NPs, MAiD , euthanasia , assisted death , and end-of-life care . Only articles written in English were reviewed. The legalization and legislation of MAiD is new in many countries; therefore, studies that were greater than twenty years old were excluded, no further exclusion criteria set for country.

Items from surveys designed to measure similar variables in other health care providers and geographic contexts were placed in a table and similar items were collated and revised into a single item. Then key variables were identified from the empirical literature on nurses and MAiD in Canada and checked against the items derived from the surveys to ensure that each of the key variables were represented. For example, conscientious objection has figured prominently in the Canadian literature, but there were few items that assessed knowledge of conscientious objection in other surveys and so items were added [ 15 , 21 , 28 , 29 ]. Finally, four case studies were added to the survey to address the anticipated changes to the Canadian legislation. The case studies were based upon the inclusion of mature minors, advanced consent, and mental disorder as the sole underlying medical condition. The intention was to assess nurses’ beliefs and comfort with these potential legislative changes.

Phase 2. Item refinement through expert panel review

The goal of phase 2 was to refine and prioritize the proposed survey items identified in phase 1 using a modified e-Delphi approach to achieve consensus among an expert panel [ 26 ]. Items from phase 1 were presented to an expert faculty panel using a Qualtrics (Provo, UT) online survey. Panel members were asked to review each item to determine if it should be: included, excluded or adapted for the survey. When adapted was selected faculty experts were asked to provide rationale and suggestions for adaptation through the use of an open text box. Items that reached a level of 75% consensus for either inclusion or adaptation were retained [ 25 , 26 ]. New items were categorized and added, and a revised survey was presented to the panel of experts in round 2. Panel members were again asked to review items, including new items, to determine if it should be: included, excluded, or adapted for the survey. Round 2 of the modified e-Delphi approach also included an item prioritization activity, where participants were then asked to rate the importance of each item, based on a 5-point Likert scale (low to high importance), which De Vaus [ 30 ] states is helpful for increasing the reliability of responses. Items that reached a 75% consensus on inclusion were then considered in relation to the importance it was given by the expert panel. Quantitative data were managed using SPSS (IBM Corp).

Phase 3. Face validity through cognitive interviews with nursing students

The goal of phase 3 was to obtain initial face validity of the proposed survey using a sample of nursing student informants. More specifically, student participants were asked to discuss how items were interpreted, to identify confusing wording or other problematic construction of items, and to provide feedback about the survey as a whole including readability and organization [ 31 , 32 , 33 ]. The focus group was held online and audio recorded. A semi-structured interview guide was developed for this study that focused on clarity, meaning, order and wording of questions; emotions evoked by the questions; and overall survey cohesion and length was used to obtain data (see Supplementary Material 2  for the interview guide). A prompt to “think aloud” was used to limit interviewer-imposed bias and encourage participants to describe their thoughts and response to a given item as they reviewed survey items [ 27 ]. Where needed, verbal probes such as “could you expand on that” were used to encourage participants to expand on their responses [ 27 ]. Student participants’ feedback was collated verbatim and presented to the research team where potential survey modifications were negotiated and finalized among team members. Conventional content analysis [ 34 ] of focus group data was conducted to identify key themes that emerged through discussion with students. Themes were derived from the data by grouping common responses and then using those common responses to modify survey items.

Ten nursing faculty participated in the expert panel. Eight of the 10 faculty self-identified as female. No faculty panel members reported conscientious objector status and ninety percent reported general agreement with MAiD with one respondent who indicated their view as “unsure.” Six of the 10 faculty experts had 16 years of experience or more working as a nurse educator.

Five nursing students participated in the cognitive interview focus group. The duration of the focus group was 2.5 h. All participants identified that they were born in Canada, self-identified as female (one preferred not to say) and reported having received some instruction about MAiD as part of their nursing curriculum. See Tables  1 and 2 for the demographic descriptors of the study sample. Study results will be reported in accordance with the study phases. See Fig.  1 for an overview of the results from each phase.

figure 1

Fig. 1  Overview of survey development findings

Phase 1: survey item generation

Review of the literature identified that no existing survey was available for use with nursing students in the Canadian context. However, an analysis of themes across qualitative and quantitative studies of physicians, medical students, nurses, and nursing students provided sufficient data to develop a preliminary set of items suitable for adaptation to a population of nursing students.

Four major themes and factors that influence knowledge, attitudes, and beliefs about MAiD were evident from the literature: (i) endogenous or individual factors such as age, gender, personally held values, religion, religiosity, and/or spirituality [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ], (ii) experience with death and dying in personal and/or professional life [ 35 , 40 , 41 , 43 , 44 , 45 ], (iii) training including curricular instruction about clinical role, scope of practice, or the law [ 23 , 36 , 39 ], and (iv) exogenous or social factors such as the influence of key leaders, colleagues, friends and/or family, professional and licensure organizations, support within professional settings, and/or engagement in MAiD in an interdisciplinary team context [ 9 , 35 , 46 ].

Studies of nursing students also suggest overlap across these categories. For example, value for patient autonomy [ 23 ] and the moral complexity of decision-making [ 37 ] are important factors that contribute to attitudes about MAiD and may stem from a blend of personally held values coupled with curricular content, professional training and norms, and clinical exposure. For example, students report that participation in end of life care allows for personal growth, shifts in perception, and opportunities to build therapeutic relationships with their clients [ 44 , 47 , 48 ].

Preliminary items generated from the literature resulted in 56 questions from 11 published sources (See Table  3 ). These items were constructed across four main categories: (i) socio-demographic questions; (ii) end of life care questions; (iii) knowledge about MAiD; or (iv) comfort and willingness to participate in MAiD. Knowledge questions were refined to reflect current MAiD legislation, policies, and regulatory frameworks. Falconer [ 39 ] and Freeman [ 45 ] studies were foundational sources for item selection. Additionally, four case studies were written to reflect the most recent anticipated changes to MAiD legislation and all used the same open-ended core questions to address respondents’ perspectives about the patient’s right to make the decision, comfort in assisting a physician or NP to administer MAiD in that scenario, and hypothesized comfort about serving as a primary provider if qualified as an NP in future. Response options for the survey were also constructed during this stage and included: open text, categorical, yes/no , and Likert scales.

Phase 2: faculty expert panel review

Of the 56 items presented to the faculty panel, 54 questions reached 75% consensus. However, based upon the qualitative responses 9 items were removed largely because they were felt to be repetitive. Items that generated the most controversy were related to measuring religion and spirituality in the Canadian context, defining end of life care when there is no agreed upon time frames (e.g., last days, months, or years), and predicting willingness to be involved in a future events – thus predicting their future selves. Phase 2, round 1 resulted in an initial set of 47 items which were then presented back to the faculty panel in round 2.

Of the 47 initial questions presented to the panel in round 2, 45 reached a level of consensus of 75% or greater, and 34 of these questions reached a level of 100% consensus [ 27 ] of which all participants chose to include without any adaptations) For each question, level of importance was determined based on a 5-point Likert scale (1 = very unimportant, 2 = somewhat unimportant, 3 = neutral, 4 = somewhat important, and 5 = very important). Figure  2 provides an overview of the level of importance assigned to each item.

figure 2

Ranking level of importance for survey items

After round 2, a careful analysis of participant comments and level of importance was completed by the research team. While the main method of survey item development came from participants’ response to the first round of Delphi consensus ratings, level of importance was used to assist in the decision of whether to keep or modify questions that created controversy, or that rated lower in the include/exclude/adapt portion of the Delphi. Survey items that rated low in level of importance included questions about future roles, sex and gender, and religion/spirituality. After deliberation by the research committee, these questions were retained in the survey based upon the importance of these variables in the scientific literature.

Of the 47 questions remaining from Phase 2, round 2, four were revised. In addition, the two questions that did not meet the 75% cut off level for consensus were reviewed by the research team. The first question reviewed was What is your comfort level with providing a MAiD death in the future if you were a qualified NP ? Based on a review of participant comments, it was decided to retain this question for the cognitive interviews with students in the final phase of testing. The second question asked about impacts on respondents’ views of MAiD and was changed from one item with 4 subcategories into 4 separate items, resulting in a final total of 51 items for phase 3. The revised survey was then brought forward to the cognitive interviews with student participants in Phase 3. (see Supplementary Material 1 for a complete description of item modification during round 2).

Phase 3. Outcomes of cognitive interview focus group

Of the 51 items reviewed by student participants, 29 were identified as clear with little or no discussion. Participant comments for the remaining 22 questions were noted and verified against the audio recording. Following content analysis of the comments, four key themes emerged through the student discussion: unclear or ambiguous wording; difficult to answer questions; need for additional response options; and emotional response evoked by questions. An example of unclear or ambiguous wording was a request for clarity in the use of the word “sufficient” in the context of assessing an item that read “My nursing education has provided sufficient content about the nursing role in MAiD.” “Sufficient” was viewed as subjective and “laden with…complexity that distracted me from the question.” The group recommended rewording the item to read “My nursing education has provided enough content for me to care for a patient considering or requesting MAiD.”

An example of having difficulty answering questions related to limited knowledge related to terms used in the legislation such as such as safeguards , mature minor , eligibility criteria , and conscientious objection. Students were unclear about what these words meant relative to the legislation and indicated that this lack of clarity would hamper appropriate responses to the survey. To ensure that respondents are able to answer relevant questions, student participants recommended that the final survey include explanation of key terms such as mature minor and conscientious objection and an overview of current legislation.

Response options were also a point of discussion. Participants noted a lack of distinction between response options of unsure and unable to say . Additionally, scaling of attitudes was noted as important since perspectives about MAiD are dynamic and not dichotomous “agree or disagree” responses. Although the faculty expert panel recommended the integration of the demographic variables of religious and/or spiritual remain as a single item, the student group stated a preference to have religion and spirituality appear as separate items. The student focus group also took issue with separate items for the variables of sex and gender, specifically that non-binary respondents might feel othered or “outed” particularly when asked to identify their sex. These variables had been created based upon best practices in health research but students did not feel they were appropriate in this context [ 49 ]. Finally, students agreed with the faculty expert panel in terms of the complexity of projecting their future involvement as a Nurse Practitioner. One participant stated: “I certainly had to like, whoa, whoa, whoa. Now let me finish this degree first, please.” Another stated, “I'm still imagining myself, my future career as an RN.”

Finally, student participants acknowledged the array of emotions that some of the items produced for them. For example, one student described positive feelings when interacting with the survey. “Brought me a little bit of feeling of joy. Like it reminded me that this is the last piece of independence that people grab on to.” Another participant, described the freedom that the idea of an advance request gave her. “The advance request gives the most comfort for me, just with early onset Alzheimer’s and knowing what it can do.” But other participants described less positive feelings. For example, the mature minor case study yielded a comment: “This whole scenario just made my heart hurt with the idea of a child requesting that.”

Based on the data gathered from the cognitive interview focus group of nursing students, revisions were made to 11 closed-ended questions (see Table  4 ) and 3 items were excluded. In the four case studies, the open-ended question related to a respondents’ hypothesized actions in a future role as NP were removed. The final survey consists of 45 items including 4 case studies (see Supplementary Material 3 ).

The aim of this study was to develop and validate a survey that can be used to track the growth of knowledge about MAiD among nursing students over time, inform training programs about curricular needs, and evaluate attitudes and willingness to participate in MAiD at time-points during training or across nursing programs over time.

The faculty expert panel and student participants in the cognitive interview focus group identified a need to establish core knowledge of the terminology and legislative rules related to MAiD. For example, within the cognitive interview group of student participants, several acknowledged lack of clear understanding of specific terms such as “conscientious objector” and “safeguards.” Participants acknowledged discomfort with the uncertainty of not knowing and their inclination to look up these terms to assist with answering the questions. This survey can be administered to nursing or pre-nursing students at any phase of their training within a program or across training programs. However, in doing so it is important to acknowledge that their baseline knowledge of MAiD will vary. A response option of “not sure” is important and provides a means for respondents to convey uncertainty. If this survey is used to inform curricular needs, respondents should be given explicit instructions not to conduct online searches to inform their responses, but rather to provide an honest appraisal of their current knowledge and these instructions are included in the survey (see Supplementary Material 3 ).

Some provincial regulatory bodies have established core competencies for entry-level nurses that include MAiD. For example, the BC College of Nurses and Midwives (BCCNM) requires “knowledge about ethical, legal, and regulatory implications of medical assistance in dying (MAiD) when providing nursing care.” (10 p. 6) However, across Canada curricular content and coverage related to end of life care and MAiD is variable [ 23 ]. Given the dynamic nature of the legislation that includes portions of the law that are embargoed until 2024, it is important to ensure that respondents are guided by current and accurate information. As the law changes, nursing curricula, and public attitudes continue to evolve, inclusion of core knowledge and content is essential and relevant for investigators to be able to interpret the portions of the survey focused on attitudes and beliefs about MAiD. Content knowledge portions of the survey may need to be modified over time as legislation and training change and to meet the specific purposes of the investigator.

Given the sensitive nature of the topic, it is strongly recommended that surveys be conducted anonymously and that students be provided with an opportunity to discuss their responses to the survey. A majority of feedback from both the expert panel of faculty and from student participants related to the wording and inclusion of demographic variables, in particular religion, religiosity, gender identity, and sex assigned at birth. These and other demographic variables have the potential to be highly identifying in small samples. In any instance in which the survey could be expected to yield demographic group sizes less than 5, users should eliminate the demographic variables from the survey. For example, the profession of nursing is highly dominated by females with over 90% of nurses who identify as female [ 50 ]. Thus, a survey within a single class of students or even across classes in a single institution is likely to yield a small number of male respondents and/or respondents who report a difference between sex assigned at birth and gender identity. When variables that serve to identify respondents are included, respondents are less likely to complete or submit the survey, to obscure their responses so as not to be identifiable, or to be influenced by social desirability bias in their responses rather than to convey their attitudes accurately [ 51 ]. Further, small samples do not allow for conclusive analyses or interpretation of apparent group differences. Although these variables are often included in surveys, such demographics should be included only when anonymity can be sustained. In small and/or known samples, highly identifying variables should be omitted.

There are several limitations associated with the development of this survey. The expert panel was comprised of faculty who teach nursing students and are knowledgeable about MAiD and curricular content, however none identified as a conscientious objector to MAiD. Ideally, our expert panel would have included one or more conscientious objectors to MAiD to provide a broader perspective. Review by practitioners who participate in MAiD, those who are neutral or undecided, and practitioners who are conscientious objectors would ensure broad applicability of the survey. This study included one student cognitive interview focus group with 5 self-selected participants. All student participants had held discussions about end of life care with at least one patient, 4 of 5 participants had worked with a patient who requested MAiD, and one had been present for a MAiD death. It is not clear that these participants are representative of nursing students demographically or by experience with end of life care. It is possible that the students who elected to participate hold perspectives and reflections on patient care and MAiD that differ from students with little or no exposure to end of life care and/or MAiD. However, previous studies find that most nursing students have been involved with end of life care including meaningful discussions about patients’ preferences and care needs during their education [ 40 , 44 , 47 , 48 , 52 ]. Data collection with additional student focus groups with students early in their training and drawn from other training contexts would contribute to further validation of survey items.

Future studies should incorporate pilot testing with small sample of nursing students followed by a larger cross-program sample to allow evaluation of the psychometric properties of specific items and further refinement of the survey tool. Consistent with literature about the importance of leadership in the context of MAiD [ 12 , 53 , 54 ], a study of faculty knowledge, beliefs, and attitudes toward MAiD would provide context for understanding student perspectives within and across programs. Additional research is also needed to understand the timing and content coverage of MAiD across Canadian nurse training programs’ curricula.

The implementation of MAiD is complex and requires understanding of the perspectives of multiple stakeholders. Within the field of nursing this includes clinical providers, educators, and students who will deliver clinical care. A survey to assess nursing students’ attitudes toward and willingness to participate in MAiD in the Canadian context is timely, due to the legislation enacted in 2016 and subsequent modifications to the law in 2021 with portions of the law to be enacted in 2027. Further development of this survey could be undertaken to allow for use in settings with practicing nurses or to allow longitudinal follow up with students as they enter practice. As the Canadian landscape changes, ongoing assessment of the perspectives and needs of health professionals and students in the health professions is needed to inform policy makers, leaders in practice, curricular needs, and to monitor changes in attitudes and practice patterns over time.

Availability of data and materials

The datasets used and/or analysed during the current study are not publicly available due to small sample sizes, but are available from the corresponding author on reasonable request.

Abbreviations

British Columbia College of Nurses and Midwives

Medical assistance in dying

Nurse practitioner

Registered nurse

University of British Columbia Okanagan

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Acknowledgements

We would like to acknowledge the faculty and students who generously contributed their time to this work.

JS received a student traineeship through the Principal Research Chairs program at the University of British Columbia Okanagan.

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JS made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and drafting and substantively revising the work. JS has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. BP made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and drafting and substantively revising the work. BP has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. LO made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and substantively revising the work. LO has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. NDO made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and substantively revising the work. NDO has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. HS made substantial contributions to drafting and substantively revising the work. HS has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

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Schroeder, J., Pesut, B., Olsen, L. et al. Developing a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in Medical Assistance in Dying (MAiD): a mixed method modified e-Delphi study. BMC Nurs 23 , 326 (2024). https://doi.org/10.1186/s12912-024-01984-z

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Murr (ムル, Muru ) is a character from Jun Mochizuki 's The Case Study of Vanitas . He is the pet cat of Noé Archiviste , having been with him since his childhood alongside the de Sades and continuing to accompany him all the way to adulthood. Murr seems to have been originally owned by Louis and resided in Averoigne alongside the boy, his grandfather , and Noé who had been taken in as the latter's student—up until his owner's untimely death, by which Noé came to be his primary caretaker. Thus when Noé receives an order from his Teacher to travel to Paris in search of the Book of Vanitas , Murr follows.

Throughout Noé and Vanitas 's journey to save every curse-bearing Vampire they can, Murr remains their grumpy yet faithful companion.

Icon murr transparent

  • 1 Appearance
  • 2 Personality
  • 4 Powers and Abilities
  • 5.1 Noé Archiviste
  • 5.2 Vanitas
  • 5.3 Amelia Ruth
  • 5.4 Nox and Manet
  • 5.5 Parks Orlok
  • 5.6 Louis de Sade
  • 6 Appearances
  • 8 References
  • 9 Navigation

Appearance [ ]

MangaVan7 - Murr's mask

Murr in Bal Masqué.

Murr is a cat with a very fluffy white coat, in particular his tail having the most fluff and volume. He has heterochromatic eyes, with the right being purple and the left being blue. His neck is decorated with a jeweled, purple ribbon. During the Bal Masqué arc, Murr also wore a small mask which had similar a design to Dominique's mask.

Personality [ ]

Murr seems to be in a constant state of annoyance in regards to everyone and everything around him. He often ambushes others and will even scratch his owner Noé. He allows himself to be held and doted on, although he maintains a frown of irritability throughout it. Murr prefers the company of women to men, escaping from his cage so that Amelia Ruth can cuddle him upon their meeting. He seems to enjoy spending time with Count Orlok, Manet, Nox, and Amelia. He also seems to have had a good relationship with Louis.

Ep1 Murr's Surprise Appearance

Murr's surprise appearance.

Murr is inside of a cat carrier throughout Noé’s journey to Paris on the airship. After spying Amelia Ruth he easily escapes from the carrier and delightedly cuddles with her.

Powers and Abilities [ ]

  • Longevity : Murr is seen playing with Louis as a full- grown cat approximately ten years before the start of the series, and has not appeared to age in any way since then.
  • Intelligence :

Relationships [ ]

Noé archiviste [ ].

Murr has a surface dislike for Noé, often scratching him and ignoring him. Despite this, Murr seems to care for Noé at some level, tolerating his company and excitability, and often perching on his shoulder.

Vanitas [ ]

Murr vani2

Murr on Vanitas' lap.

Murr seems to enjoy Vanitas' company, being occasionally seen sleeping or sitting on his lap. Noé has also questioned why Murr likes Vanitas so much, going so far as to ask if Murr was bribed or if Vanitas was actually a woman. Apparently, Vanitas is the type of person who doesn't care about cats, so he gets attention from them instead.

Amelia Ruth [ ]

While aboard La Baleine, Murr escaped from his carrier and accosted Amelia. Amelia was initially frightened, but after recovering from the surprise, she was delighted to have his company, commenting on Murr's warmth. She later greets the cat again after being freed from imprisonment, happy to see him.

Nox and Manet [ ]

Having been left behind when Noé and Vanitas left to track down Thomas Berneux , Murr went back to Galerie Vivienne where he was discovered by Nox and Manet. Nox and Manet initially were going to remove Murr from Count Orlok's presence out of fear that the count would find him noisy. They held him roughly, causing Murr to attack them out of aggravation. After being scolded by Count Orlok for their poor treatment of Murr, they joined the count in fondly doting on the cat, playing with Murr and feeding him, and eventually becoming great friends.

Parks Orlok [ ]

Count Orlok scolded Nox and Manet for not treating Murr properly and proceeded to dote on Murr, using cat toys to play with him. The two are now great friends.

Louis de Sade [ ]

Louis and Murr seem to have been friends while Louis was alive. Louis is seen interacting with Murr during a flashback, and when Dominique pictures Louis as an adult, Murr is perched on his shoulder.

Flute manga

Murr and Flute.

Flute is the small black cat that lives in Hôtel Chouchou . Murr has a big crush on her, but she always takes him very lightheartedly. However, they can be frequently seen hanging out together.

Appearances [ ]

  • Mémoire 1: Vanitas — In The Event of Rusty Hopes (First Appearance)
  • Mémoire 2: Noé — In the City of Flowers
  • Mémoire 5: Archiviste — Fangs That Reveal Blood
  • Mémoire 6: Altus — Other World
  • Mémoire 7: Bal Masqué — Night Of Sneering Masks
  • Mémoire 13: Glissando — Glissando
  • Mémoire 14: Catacombes — Where The Dead Sleep
  • Mémoire 23: Au Pas Camarade — Pace
  • Mémoire 24: Forêt d'argent — Chance Encounter
  • Mémoire 29: Château de Sorcière — The Witch and the Youth
  • Mémoire 30: Strascinando — Tremolo
  • Mémoire 33: Cauchemar — Rumble
  • Mémoire 34: Jean-Jacques — The Vampire of the Chastels (Part One)
  • Mémoire 34.5: Jean-Jacques — The Vampire of the Chastels (Part Two)
  • Mémoire 43: Encens Restant — Lingering Scent of the Dream
  • Mémoire 44: Mal d'Amour — The Incurable Illness (Part One)
  • Entracte: Jours Bruyants — Tales of Lost Children
  • Mémoire 61: Jeu de paume — Court Tennis (Part One)
  • Mémoire 61.5: Jeu de paume — Court Tennis (Part Two)
  • Mémoire 62: Bourdonnement — Wingbeats of Scattered Thought (Part One)
  • Mémoire 1: Vanitas -In the Event of Rusty Hopes- (First Appearance)
  • Mémoire 2: Noé -In the City of Flowers-
  • Mémoire 3: Archiviste -Fangs That Lay Bare Blood-
  • Mémoire 4: Bal Masqué -Night of Mocking Masks-
  • Mémoire 5: Réminiscence -Friends-
  • Mémoire 6: Salvatio -Questions-
  • Mémoire 8: Catacombes -Where Death Slumbers-
  • Mémoire 12: Deux Ombres -Point of Departure-
  • Mémoire 13: Forêt d'argent -Chance Encounter-
  • Mémoire 14: Château de Sorcière -The Witch and the Young Man-
  • Mémoire 15: Oiseau et ciel -The d'Apchiers' Vampire-
  • Mémoire 16: Chasse aux Vampires -The Beast-
  • Mémoire 19: Canorus -Snow Flower-
  • Mémoire 20: Mal d'amour -The Incurable Disease-
  • Mémoire 24: Après la pluie -His Wish-

(*) - Denotes that the character did not appear physically, but as a part of another character's memories.

Miaou miaou1

  • "Murr" is a reference to the titular character of The Life and Opinions of the Tomcat Murr , [1] a satirical novel by Ernst Theodor Amadeus Hoffmann written from the perspective of a cat who has learned how to write.
  • Murr has had a crush on two cats throughout the series so far — an unnamed white cat and Flute , who is a black a cat that lives in the hotel.
  • Jun Mochizuki drew Murr as a human for the Volume 8 omake. He appeared as a young boy with long white hair, heterochromia, and a grumpy expression. Human Murr seems to get along well with the cat versions of Noé and Dominique.

References [ ]

  • ↑ Wikipedia: The Life and Opinions of the Tomcat Murr

Navigation [ ]

  • 3 List of Characters (The Case Study of Vanitas)

IMAGES

  1. The Teacher and Noe ||| The Case Study of Vanitas Memoire 9 "Friends

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  2. The Case Study of Vanitas (2021)

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VIDEO

  1. 「Vanitas no Carte」The Case Study of Vanitas OST

  2. the case study of vanitas Part-2 #ms_fact #anime #short

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  4. Junior Teacher Case Update |Next Hearing 29

  5. Cursed vampire (the case of a study vanitas)#vanitas #jin #thecaseofstudyvanitas #anime #animeedits

  6. The case study of vanitas #book of vanitas

COMMENTS

  1. The Teacher

    The Teacher, (先 (せん) 生 (せい) , Sensei) also known as The Shapeless One (貌 (かたち) 持 (も) たざる 者 (もの) , Katachi Motazaru-mono), and the Comte de Saint Germain (サンジェルマン 伯 (はく) 爵 (しゃく) , San Jeruman Hakushaku), is a character from Jun Mochizuki's The Case Study of Vanitas.As the Teacher is known to frequently change his name, being so ...

  2. The Case Study of Vanitas

    The Case Study of Vanitas (Japanese: ヴァニタスの 手記 ( カルテ ), Hepburn: Vanitasu no Karute) is a Japanese manga series written and illustrated by Jun Mochizuki.It has been serialized in Square Enix's shōnen manga magazine Monthly Gangan Joker since December 2015. In North America, the manga is published in English by Yen Press.. The Case Study of Vanitas is set in a ...

  3. The Case Study of Vanitas

    The Case Study of Vanitas (ヴァニタスの手記 (カルテ) , Vanitasu no Karute) is the second main manga series by mangaka Jun Mochizuki following the completion of her one-shot Crimson-Shell and her first main series Pandora Hearts. The series launched on December 22nd 2015 and is being published monthly in Gangan Joker magazine. Yen Press publishes the official English localization ...

  4. The Case Study of Vanitas

    Watch The Case Study of Vanitas on Crunchyroll! https://got.cr/Watch-TCSOVYTCrunchyroll Collection brings you the latest clips, OPs, and more from your favor...

  5. Vanitas no Karte (The Case Study of Vanitas)

    In 19th century Paris, Noé Archiviste is searching for the fabled Book of Vanitas. Whilst traveling aboard an airship, he is saved from a vampire attack by an eccentric doctor who calls himself Vanitas and carries the very tome he seeks. Ironically, the self-proclaimed vampire specialist is a mere human who inherited both his name and the book ...

  6. Vanitas no Karte (The Case Study of Vanitas)

    Scorned by others of his kind for being born under a blue moon, the vampire Vanitas grew afraid and desolate. According to legend, he created a cursed grimoire known as the "Book of Vanitas," and it is said he would one day use it to bring retribution upon all vampires of the crimson moon. In 19th century Paris, Noé Archiviste is searching for the fabled Book of Vanitas. Whilst traveling ...

  7. Vanitas no Karte (The Case Study of Vanitas)

    Characters, voice actors, producers and directors from the anime Vanitas no Karte (The Case Study of Vanitas) on MyAnimeList, the internet's largest anime database. Scorned by others of his kind for being born under a blue moon, the vampire Vanitas grew afraid and desolate. According to legend, he created a cursed grimoire known as the "Book of Vanitas," and it is said he would one day use it ...

  8. The Case Study of Vanitas (English Dub)

    Watch The Case Study of Vanitas (English Dub) Night of Mocking Masks, on Crunchyroll. The Teacher explains the World Formula theory. Vanitas is put off by Noé and Dominique's relationship.

  9. The Case Study of Vanitas

    Released on Dec 21, 2021. 3.1K. 17. The Teacher explains the World Formula theory. Vanitas is put off by Noé and Dominique's relationship. Dominique rakes Vanitas over the coals. Vanitas ...

  10. Watch The Case Study of Vanitas

    Stream and watch the anime The Case Study of Vanitas on Crunchyroll. In nineteenth-century France, humans and vampires coexist. The young vampire Noé is traveling to Paris in search of The Book ...

  11. The Case Study of Vanitas (TV Series 2021-2022)

    S1.E21 ∙ Scars. Sat, Mar 12, 2022. Dominique is taken hostage by Vanitas' adoptive brother, Mikhail, who sends a letter to Noé with a lock of her hair. Noé meets Mikhail in an amusement park and after threatening to harm Domi, he forces Noé to drink his blood to reveal his memories.

  12. The Case Study of Vanitas: Season 1, Episode 4

    Watch The Case Study of Vanitas — Season 1, Episode 4 with a subscription on Hulu, or buy it on Prime Video. The Teacher explains the World Formula theory; Vanitas is put off by Noé and ...

  13. The Case Study of Vanitas: Season 1

    Watch The Case Study of Vanitas — Season 1 with a subscription on Hulu, or buy it on Prime Video. In 19th-century Paris, young vampire Noé finds the "Book of Vanitas" in the hands of a doctor ...

  14. Vanitas (The Case Study of Vanitas)

    Vanitas (Japanese: ヴァニタス, Hepburn: Vanitasu) is the fictional protagonist and title character of the manga series The Case Study of Vanitas, which was written and illustrated by Jun Mochizuki.The character was named Vanitas of the Blue Moon, making him part of the Blue Moon clan with some vampire abilities.Vanitas possesses a grimoire called The Book of Vanitas (ヴァニタスの書 ...

  15. The Case Study of Vanitas Episode 24

    The Mastermind Behind the Nightmare. Whenever a finale comes around, the absence of the opening theme really adds that excitement! The Case Study of Vanitas episode 24 did an absolutely amazing job in making those first minutes an emotional and epic one. From the aftermath of Vanitas and Noé's fight, their silent breakdowns, Mikhail's ...

  16. Noé Archiviste

    Noé Archiviste (ノエ・アルシヴィスト, Noe Arushivisuto) is a central protagonist of Jun Mochizuki's The Case Study of Vanitas. A Vampire raised in the rural French village of Averoigne, Noé is sent to see Paris for the first time to complete an assignment given to him by his Teacher. Instructed to locate the Book of Vanitas and discern its "true character," he encounters Vanitas ...

  17. The Case Study Of Vanitas

    The Case Study of Vanitas is a perfect blend of Parisian backgrounds and vampire hunting. ... he meets Noé Archiviste, a man seeking the Book under the orders of his teacher. Noé is very caring ...

  18. Teacher Voice

    Teacher. John Burgmeier is the English dub voice of Teacher in The Case Study of Vanitas, and Akira Ishida is the Japanese voice. TV Show: The Case Study of Vanitas.

  19. The Case Study of Vanitas (2021)

    The Case Study of Vanitas (2021) Anime Series | 2D Animation | Action, Drama, Supernatural. Voice Director: David Wald US Release: Aug 6, 2021 - Apr 29, 2022 Japan Release: Jul 3, 2021 - Apr 2, 2022. ... Teacher voiced by John Burgmeier and 1 other . Murr voiced by Marianne Bray and 1 other .

  20. List of The Case Study of Vanitas episodes

    The anime television series The Case Study of Vanitas is based in on the manga series of the same name written and illustrated by Jun Mochizuki.On March 28, 2021, it was announced at AnimeJapan that the series would be receiving an anime television series adaptation by Bones.It was directed by Tomoyuki Itamura, with scripts overseen by Deko Akao and character designs by Yoshiyuki Ito.

  21. Strongest Characters in The Case Study of Vanitas: Vanitas, Noe, & More

    The Case Study of Vanitas is a story based in a fictional 19th-century Paris where humans and vampires share the city. The story revolves around Vanitas and his companion, Noe Archiviste.

  22. Vanitas

    Vanitas (ヴァニタス, Vanitasu) is a protagonist and the titular character of Jun Mochizuki's The Case Study of Vanitas. Contrary to the legend of Vanitas of the Blue Moon, Vanitas claims to be "an average human being" who happened to inherit the Book of Vanitas. It is his stated intention to save the Vampire race by any means possible, using the Book of Vanitas not to spread Malnomen but ...

  23. Vanitas

    103 likes, 2 comments - vanitas_san123 on May 17, 2024: "Vanitas ----- Anime The Case Study of Vanitas -----...".

  24. Frontiers

    It has been estimated in recent studies that more than 1.5 million children worldwide lost a caregiver due to the COVID-19 pandemic. Childhood bereavement is associated with heightened risks of impaired academic and social performance, mental health issues, substance use disorders, and higher mortality rates. Yet children may receive insufficient support post-loss. Although the role of school ...

  25. How to teach your kids body boundaries, consent to keep them safer

    'We're teaching them how to be safe' San Antonio mom Kati Zech embraces the love and chaos of motherhood, with a 4-year-old, 2-year-old and another due in the fall.

  26. Charlatan

    Charlatan (シャルラタン, Sharuratan) is the major antagonistic group from Jun Mochizuki's The Case Study of Vanitas. It is an organization completely shrouded in mystery, with its full ranks, the identity of its members, the full scope of its powers, and even its true intentions and desires utterly unknown as of yet. They are the organization enabling Naenia and her spreading of Malnomen ...

  27. Developing a survey to measure nursing students' knowledge, attitudes

    Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. Canada's legislation is the first to permit Nurse Practitioners (NP) to serve as independent MAiD assessors and providers. Registered Nurses' (RN) also have important roles in MAiD that include MAiD care coordination; client and family teaching and support, MAiD procedural quality; healthcare provider and public education ...

  28. Murr

    Murr (ムル, Muru) is a character from Jun Mochizuki's The Case Study of Vanitas.He is the pet cat of Noé Archiviste, having been with him since his childhood alongside the de Sades and continuing to accompany him all the way to adulthood. Murr seems to have been originally owned by Louis and resided in Averoigne alongside the boy, his grandfather, and Noé who had been taken in as the ...