Theses Doctoral

Fostering Empathy in Undergraduate Nursing Students: Improving Simulation Design to Enhance Learning in the Affective Domain

Roberts, Michele Livich

Healthcare simulation is a teaching strategy rooted in cognitive, constructivist, and social learning theories. Simulation–based learning experiences offer a replacement for traditional clinical learning and are widely used across all levels of nursing education. Most simulation activities are focused on student application of cognitive knowledge to clinical situations or practicing psychomotor skills, with little attention paid to student development of core nursing values such as caring and compassion. In fact, few studies have empirically assessed the usefulness of simulation for helping student nurses develop affective characteristics such as empathy. A quasi–experimental control group study was conducted to evaluate affective learning in student nurses during a simulated clinical activity. Students randomized to the treatment condition watched a lesson on the importance of empathy as a professional nursing value along with a vignette in which an actor playing the simulated patient shared a narrative story that detailed aspects of his social, emotional, and physical well–being. Subjects who received the intervention had a greater and statistically significant increase in empathy score than those in the control condition. Students exposed to the intervention also had higher observed empathy scores, but differences between groups were not statistically significant.

Since narratives can be useful for helping health profession students understand patient perspectives on their health and well–being, the concept of narrative transportation (i.e., immersion in narrative accounts or stories) was used to assess student engagement in the simulated learning activity. Students in the treatment condition had higher but non–statistically significant engagement scores in response to the intervention. Last, associations between empathy, emotional intelligence, and nursing competence were assessed. Positive and statistically significant relationships between empathy and emotional intelligence, emotional intelligence and nursing competence, and empathy and nursing competence were observed. Further analysis indicated that emotional intelligence partially mediated the relationship between empathy and nursing competence in this sample. The findings of this study demonstrated that patient narratives were useful for facilitating affective learning during simulated clinical activities. The observed results also provide insight on the relationship between affective characteristics and competency development in student nurses.


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More About This Work

Academic Units
Health and Behavior Studies
Thesis Advisors
Kaur, Tresa
O'Connell, Kathleen
Ed.D., Teachers College, Columbia University
Published Here
June 2, 2021