Effectiveness of empathy clinical education for children's nursing students: A quasi-experimental study

BackgroundEmpathy is a central competence for nursing students in delivering compassionate care. Empathy training might improve the communication skills in children's nursing students.ObjectivesTo evaluate the effectiveness of the Knowledge, Simulation, and Sharing training programme on empathy skills among children's nursing students.DesignA controlled pre-post intervention study with a quasi-experimental design.SettingTertiary children's hospital in China.ParticipantsChildren's nursing students (n = 250) in clinical internship.MethodsA Knowledge, Simulation, and Sharing (KSS) module related to empathy learning was developed and tested during a 10-month period in 2017. Nursing students were divided into an experimental group (n = 125) and control group (n = 125). Both groups received the standard internship programme. The experimental group received the KSS training. Outcome measures were: Jefferson Scale of Empathy-Health Professions Student, Clinical Communication Competence Scale and Professional Identity Scale.ResultsAt the end of the internship the experimental groups had significantly higher empathy scores than the control group (114.57 versus 110.36; p = .016). The communication skills improved significantly in the experimental group after the training; experimental group mean 90.22 versus control group mean 87.41 (p = .042). The professional identity scores were significantly higher in the experimental group at the end of the internship compared to the control group (mean 116.43 versus 107.68; p < .001). Subgroup analysis revealed only significant differences on professional identity outcomes between experimental and control groups on diploma level (mean 115.78 versus 107.72; p < .001); and bachelor's level (mean 120.05 versus 108.00; p < .016).ConclusionThe KSS training can enhance empathy and communication skills and the professional identity in children's nursing students. Further long-term effectiveness of the training needs to be tested, ideally with reported outcomes measures of children and parents.     

Empathy in health professional students: A comparative cross-sectional study

BackgroundIt has been shown that empathy strengthens the relationship between patients and health professionals and also improves patient and health professional satisfaction, which helps promote the best clinical outcomes. Empathy is considered an essential prerequisite for a nurse to effectively care for a patient and for a holistic understanding of a patient's perspective in a student population.ObjectivesThe main aim was to compare empathy levels between health professional students attending different university courses.DesignA comparative study with a cross-sectional approach was conducted in two successive academic year cohorts of 1st year health professional students at a public Italian university.Participants and MethodsA sample of 1st year health professional students at a public Italian university was investigated using the Jefferson Scale of Empathy Health Professional Students version (JSE-HPS).ResultsOverall, 502 health professional students were included in the study. The students in nursing showed significantly higher empathy levels than the students in other health professions. Furthermore, the female students were found to exhibit significantly more overall empathy than the male students were.ConclusionsThe undergraduate nursing students showed a significantly higher mean score of empathy measured by the Jefferson Scale of Empathy Health Professional Students version (JSE-HPS) than the students attending other health undergraduate courses. This could mean that a particular aptitude in establishing a help-relationship with other people exists among the students that choose to become a nurse.     

Effects of video-recorded role-play and guided reflection on nursing student empathy,caring behavior and competence: A two-group pretest-posttest study

AimThe study examined the differences in nursing student empathy, caring behavior and competence between the experimental and control groups before and after educational intervention and to predict the factors affecting their core competencies.BackgroundEducating nursing students in empathy and caring behaviors before entering clinical practice is challenging.DesignWe used a two-group pretest and post-test quasi-experimental design.MethodsFirst-year nursing students from medical schools in Taiwan participated in our study. Data were collected between March and May 2022. The learning method used with the intervention group was role-playing with videos and guided reflection. The control group was exposed to traditional curriculum. Empathy, caring behavior and competence were measured using the Jefferson Scale of Empathy- Healthcare Providers, the Caring Behaviors Scale and the Nursing Student Competence Scale.ResultA total of 72 participants (40 in the experimental group and 32 in the control group) were included in the final statistical analysis. The response rate was 92%. Statistically significant differences in nursing student empathy, caring behavior and competence were observed between the experimental and control groups (p < .05). The η² effect levels were 0.083, 0.223 and 0.270. Higher caring behavior scores were significantly associated with higher nursing student competence scores (β = 0.81, 95% CI:0.66–0.97).ConclusionsEducation based on video role-play and guided reflection improved empathy, caring behavior and nursing competence in first-year nursing students.     

The effect of structured empathy education on empathy competency of undergraduate nursing interns: A quasi-experimental study

BackgroundEmpathy is a crucial element in fostering a positive relationship between nurses and patients. Recent research indicates that the degree of empathy in nursing students declines as they gain education or experience. A number of teaching strategies have been used to improve nursing students' empathy competence levels. However, little is currently known about how empathy is best taught or enhanced in senior nursing students in China.ObjectivesTo implement a structured empathy educational program as developed from the Delphi technique, as well as to evaluate its effects on empathy competence among undergraduate nursing interns.DesignThis study is quasi-experimental, with two-group comparison.ParticipantsUndergraduate nursing students in their fourth year (n = 118) were recruited from an affiliated teaching hospital in Wuhan, Central Part of China, between January 2018 and March 2018.MethodsA convenience sample of 118 undergraduate nursing interns were recruited from a teaching hospital in Wuhan and assigned to either the intervention or the control group according to their preference. Participants in the intervention group had received a 2-week, 12-hour structured empathy-related educational program (two sessions per week, 3 h per session), whereas the control group received no intervention. The Jefferson Scale of Empathy-Health Providers (JSE-HPs) was used to assess students' empathy levels before and after the intervention.ResultsAn independent samples t-test revealed that scores of empathy competence levels in the intervention group were significantly higher than those in the control group following the intervention. Three domains of empathy competence level were also significantly higher in the intervention group after the two weeks' training relative to the control group, namely: perspective taking, compassionate care, and standing in the patient's shoes.ConclusionsThis modified empathy educational program may prove beneficial in improving the empathy competence level of undergraduate nursing interns.     

Using Empathetic CAre and REsponse (ECARE) in improving empathy and confidence among nursing and medical students when managing dangerous,aggressive and violent patients in the clinical setting

BackgroundThe use of physical restraint to curtail dangerous or extremely disruptive behaviours in patients has been an established practice to help ensuring safety in healthcare providers' work environment. However, many have deemed it unnecessary and overused with reported negligence on patients' basic needs during its implementation. Studies have shown that having empathy and non-judgmental attitudes are vital in reducing and eliminating the use of restraint.ObjectivesTo explore whether experiential learning will improve empathy and confidence, among nursing and medical students when managing dangerous, aggressive, and violent patients.DesignA pre- and post-test, same group quasi-experimental design was used to explore the effectiveness of using the Empathetic CAre and REsponse (ECARE), an experiential learning session to equip nursing and medical students on managing dangerous, aggressive, and violent patients. Outcome measures include students' confidence when using verbal de-escalation, physical and chemical restraint techniques. Empathy scores were also compared.SettingsA University offering both medical and nursing program from undergraduate to postgraduate level.Participants249 nursing and 50 medical students undergoing the mental health nursing module in Year 2 of their nursing program and psychiatry rotation in Year 3 of their medical education.ResultsResults showed that, for both student populations, the empathy and confidence scores significantly improved after attending ECARE. ANCOVA conducted on the post-intervention Jefferson empathy score between the populations with an adjusted baseline score revealed a statistically significant adjusted mean difference between them.ConclusionsThis study demonstrated that experiential learning could improve the learners' empathy through the integration of hands-on learning. This in turn could enhance future healthcare professionals' care quality. Experiential learning opportunities should be incorporated into existing pedagogies as this helps to improve students' confidence in managing dangerous, aggressive and violent patients, reducing the use of physical restraint, thereby enhancing the quality of patient care.     

护理实习生共情能力及其与临床学习环境、自我同情的相关性研究

目的 了解护理实习生共情能力、临床学习环境与自我同情现状，探讨护理实习生临床学习环境、自我同情与共情能力的相关性。方法 2021年9月采用便利抽样方法选取国内4所院校437名护理实习生为研究对象，以一般资料调查表、杰弗逊共情量表（护生版）、临床实习环境监督量表和自我同情量表为调查工具收集资料，对数据进行单因素分析及多因素分析。结果 护理实习生共情能力、临床学习环境、自我同情得分分别为（85.91±10.44）、（135.53±18.95）及（76.90±9.24）分。护理实习生的临床学习环境、自我同情与共情能力之间均呈显著正相关（r=0.250,P<0.01;r=0.313,P<0.01）。学历、直系亲属有无医务工作者、带教形式、科室的教学氛围、过度沉迷和自我评判为护理实习生共情能力的主要影响因素，可解释总变异的22.2%。结论 被调查护理实习生共情能力处于中等水平，护理管理者和教育者可以基于实习生的背景进行个性化共情教育，从外部因素和个人因素两方面改善护理实习生临床学习环境并提升其自我同情能力，进而提高护理实习生的共情能力。     

Level of Empathy among Medical Students in Kuwait University,Kuwait

Objectives

To evaluate the level of empathy among medical students in Kuwait University Medical School and its association with sociodemographic factors, stress levels and personality.

Subjects and Methods

A cross-sectional survey of 264 medical students was conducted in the Faculty of Medicine, Kuwait University. Empathy levels were measured using the Jefferson Scale, personality was assessed using the Zuckerman-Kuhlman Personality Scale and the Perceived Stress Scale was used to measure stress levels. Factors associated with empathy were evaluated using t test/ANOVA for categorical variables and correlation for continuous predictors.

Results

Mean empathy score was 104.6 ± 16.3. Empathy scores were significantly associated with gender, year of study, mother''s level of education, household income, satisfactory relationship with the mother and stress levels. Male medical students in their clinical years also had significantly lower empathy levels. However, factors such as grade point average, desired specialty, marital status of parents, father''s educational level and relationship with father were not significantly (p > 0.05) associated with levels of empathy. Stress scores were significantly and positively associated with empathy (r = 0.13; p = 0.041).

Conclusion

Medical students in Kuwait University had low empathy level and this may be a cause for concern; as such we suggest a possible inclusion of emphasis on empathy in the curriculum.Key Words: Empathy, Medical Students, Kuwait, Sociodemographic factors, Personality, Stress     

Similarities and differences in well-being between Australian,Saudi Arabian and South African pre-registration nursing students

BackgroundEmotional wellbeing is essential for mental and physical health. Although all university students are vulnerable to psychological distress, nursing students are particularly susceptible, and recognised at higher risk due to the stressful nature of the nursing program.AimThe aim of this cross-sectional study was to compare the demographic characteristics and emotional wellbeing with regard to levels of anxiety, depression, behavioural control, positive affect and general distress of preregistration nursing students in Australia, Saudi Arabia and South Africa.DesignCross-sectional design.MethodsA total of 1381 pre-registration nursing students from two universities in Saudi Arabia and one university in both Australia and South Africa completed the self-report measurement tool, the Mental Health Inventory. A one-way analysis of variance was used to compare well-being among pre-registration nursing students in these three countries.FindingsThe results revealed that when compared to the Australian and South African cohorts, the Saudi Arabian cohort had significantly higher anxiety (Australia M = 26.79, SD = 8.15; Saudi Arabia M = 33.12, SD = 8.24; South Africa M = 29.48, SD = 7.54), depression, (Australia M = 10.15, SD = 3.65; Saudi Arabia M = 13.10, SD = 4.49; South Africa M = 11.83, SD = 3.72), and lower scores in the Mental Health Inventory (Australia M = 152.44, SD = 28.60; Saudi Arabia M = 138.11, SD = 30.09; South Africa M = 145.67, SD = 26.32).ConclusionThere were statistically significant differences in overall psychological distress and well-being among students in the three countries. Strategies to improve emotional wellbeing and reduce the negative aspects of mental health such as anxiety and depression of preregistration nursing students are needed.     

Effectiveness of a multimodal intervention and the simulation flow to improve empathy and attitudes towards older adults in nursing students: A crossover randomised controlled trial

AimThe aims of this study were (1) to develop a multimodal intervention according to the NLN Jeffries Simulation Theory planned to improve attitudes and empathy towards older adults in undergraduate nursing students using theoretical contents, age simulation suits, and storytelling of old participants, and (2) to evaluate the influence of the simulation flow on the effectiveness of this intervention in improving attitudes and empathy towards older adults.BackgroundThe increase in longevity in recent decades has led to an increase in the demand for professionals linked to the care of the older adults. Some studies indicate that health care professionals lack empathy and understanding toward older adults. Therefore, it is essential to introduce innovative teaching strategies to improve attitudes and empathy toward older adults in future health professionals.DesignA crossover randomised controlled trial.MethodsA three-period crossover randomised controlled trial with an experimental group, a control group (that transitions to a delayed experimental group) was conducted on 70 nursing students after the initial 73 were allocated. A multimodal intervention was used that, in addition to geriatric nursing theory, incorporated complex age simulation suit and student-older adult interaction. Pre-test and post-test data were obtained through the Jefferson Scale of Empathy and Kogan’s Attitudes towards Older People Scale. Thus, students in the experimental group 1 received the following simulation flow: Geriatric Nursing Theory + Seminar with age simulation suit + student-older adult interaction. The students in the delayed experimental group 2 received this order: Geriatric Nursing Theory +Seminar without Age simulation suit + student-older adult interaction + Age simulation suit.ResultsStatistically significant differences were observed in both empathy (t = 3.155, p = 0.001, d = 0.782), and attitudes (t=3.256, p=0.001, d=0.803) when comparing control group scores (who only received the theoretical contents of the seminar) and experimental group 1 scores after receiving the full multimodal simulation (i.e. a seminar wearing an age simulation suit + volunteer interaction with an older adult). Regarding the order of educational strategies in the simulation flow, there were significant differences in the empathy scores found when both groups had received the full intervention. Accordingly, training with age simulation suits followed by storytelling provides better scores in empathy than in the opposite direction (t = 2.028, p = 0.048, d = 0.54).ConclusionsThe use of a multimodal intervention, implementing an age simulation suit and the narration of an older adult's life experiences (in this order), improves attitudes and empathy.     

Research on the formation of humanistic care ability in nursing students: A structural equation approach

ObjectiveTo construct and test a hypothetical model linking the caring ability of nursing students with empathy ability, emotional intelligence, and communication ability.MethodParticipants were 851 students from three undergraduate colleges and one junior college in China, Gansu Province. Participating students had to fulfill the following requirements: different levels of nursing majors (undergraduates or junior college students), understand the study purpose, and be willing to participate in this study. Exclusion: secondary college students. Variables were measured by the Caring Ability Inventory, Emotional Intelligence Scale, Supportive Communicative Scale, and Interpersonal Reactivity Index. Data were analyzed with structural equation modeling to explore the path relationships and mutual effects between structural elements.ResultsEmpathy (β = 0.25, P<0.001), emotional intelligence (β = 0.36, P<0.001), and communication ability (β = 0.28, P<0.001) were significantly associated with the caring ability of nursing students. Empathy was the strongest factor associated with caring ability and emotional intelligence was a partial mediator of the relationship between empathy and communication skills.ConclusionsThe nurse's humanistic care ability requires continuous learning and school education. To enhance the humanistic care ability of nursing students, nursing educators should develop target strategies to improve the ‘sympathetic ability,’ ‘emotional intelligence’ and ‘communication ability’ of nursing students.     

Using unfolding case studies to develop critical thinking skills in baccalaureate nursing students: A pilot study

BackgroundResearch has consistently demonstrated that new graduate nurses do not possess sufficient critical thinking skills when they transition to clinical practice. Unfolding case studies encourage students to participate in a number of critical thinking skills including information-seeking, logical reasoning, and analyzing of clinical data.ObjectiveThe aim of this study was to determine how the use of unfolding case studies as a learning modality affected baccalaureate students' critical thinking skills in their Adult Health Theory course. The researcher compared course examination scores earned by nursing students who were taught using traditional case studies to scores obtained by nursing students who completed unfolding case studies.SettingThe pilot study took place at a moderate-sized comprehensive university in Wisconsin.DesignA non-experimental correlational design using course examination scores data was employed to examine how the use of unfolding case studies as a learning modality affected baccalaureate students' critical thinking skills in their Adult Health Theory course.ParticipantsA total of 160 students comprised the intervention group while an additional 142 students represented the control group in the study.MethodsAn independent-samples t-test was performed to explore differences in mean scores between the intervention and control groups.ResultsResults of the t-test indicate that mean examination scores were significantly higher for the intervention group (M = 234.9, SD = 13.1) than for the control group (M = 228.2, SD = 13.3); t(299) =, p < .001.ConclusionsResults of this study suggest that unfolding case studies more effectively develop students' critical thinking skills than do a more traditional, static case study.     

护理硕士研究生共情和沟通能力的相关性研究

目的:探讨护理学硕士研究生共情和沟通能力的现状,并分析两者之间的相关性。方法:采用杰弗逊共情量表和支持性沟通量表,对137名护理学在读硕士研究生进行问卷调查。采用Pearson相关分析法探讨护理研究生共情和沟通能力的相关性。结果:护理研究生共情总分为(111.79±15.34)分,沟通能力得分为(71.41±7.90)分。共情与沟通能力总分相关系数为0.370(P<0.01)。结论:护理研究生共情和沟通能力处于中上等水平,共情和沟通能力呈低中度正相关。教育者可通过多种途径有针对性地提高护理研究生的共情水平,进而提高其沟通能力。     

Students' perceptions of interventions designed to foster empathy: An integrative review

ObjectiveEmpathy is assumed to be an important element of nursing care, and nursing educators are attempting to find ways to effectively foster empathy in their students. The purpose of this review is to gain a deeper grasp of what undergraduate nursing students are learning from interventions educators have designed to cultivate empathy by synthesizing qualitative data.Review methodsUtilizing the review methodology proposed by Whittemore and Knafl, a survey of the CINAHL, Web of Science, PubMed, and PsychINFO databases was undertaken to answer the question: What are undergraduate nursing students' perceptions of interventions designed to foster empathy?ResultsA thematic synthesis of the students' perceptions from the 17 articles meeting inclusion criteria revealed five themes: Understanding the other's experience, embodying the other's experience, becoming aware of self, informing the role of the nurse, and learning or transforming.ConclusionsAlthough additional conceptual work remains to create a coherent, complete, and parsimonious definition of empathy, the results indicate that the students are gaining many of the facets assumed to be part of the concept of empathy through these educational interventions. Immersive simulations that put students in the role of the “other” were particularly impactful, especially if they created a disorienting dilemma followed by guided reflection. These findings can help nursing educators tailor their interventions for their specific intended learning outcomes.