Empathy education in post-graduate nurses: An integrative review

Effectiveness of simulation-based interventions on empathy enhancement among nursing students: a systematic literature review and meta-analysis

BACKGROUND

This study aimed to secure and analyze evidence regarding the enhancement of nursing students' empathy through simulation-based interventions. It comprehensively analyzed self-reported emotions and reactions as primary outcomes, along with the results reported by nursing students who experienced simulation-based interventions, including empathy.

METHODS

This systematic literature review and meta-analysis investigated the effects of simulation-based interventions on enhancing empathy among nursing students. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for the systematic review and meta-analysis. The following details were considered: population, nursing students; intervention, simulation-based interventions targeting empathy enhancement; comparators, control groups without intervention or those undergoing general non-simulation-based classes; and outcomes, self-reported empathy.

RESULTS

In the systematic review of 28 studies, it was found that the use of simulation-based interventions among nursing students led to an increase in empathy, albeit with a small effect size. This was demonstrated through a pooled, random-effects meta-analysis, yielding an effect size (Hedge's g) of 0.35 (95% CI: 0.14, 0.57, p = 0.001). The results of meta-regression and subgroup analysis significantly increased in empathy for studies published after 2019 (Hedge's g = 0.52, 95% CI: 0.31 to 0.73, p < 0.001), quasi-experimental research design (Hedge's g = 0.51, 95% CI: 0.27 to 0.74, p < 0.001), more than 60 participants (Hedge's g = 0.31, 95% CI: 0.02 to 0.59, p = 0.034), and simulation-based interventions in nursing education (Hedge's g = 0.43, 95% CI: 0.22 to 0.65, p < 0.001).

CONCLUSIONS

Considering factors such as variations in sample size, research approaches, and the effects of independent studies on empathy, this systematic literature review and meta-analysis suggests that simulation-based education can significantly improve nursing students' overall empathy skills.

The current state of empathy, compassion and person-centred communication training in healthcare: An umbrella review

OBJECTIVES

This umbrella review consolidates evidence available on empathy training, its effectiveness and design mechanisms that contribute to effectiveness.

METHODS

We conducted an umbrella review (review of reviews) of empathy, compassion and person-centred communication training in healthcare published between 2018 and 2022. One reviewer screened titles, abstracts and full-text articles, with a second reviewer at full-text stage. Quality appraisal was done in duplicate. Data extraction was piloted by two reviewers and conducted by one reviewer with a quality check of all extracted data. All reviewers provided input into synthesis of results and analysis.

RESULTS

Twenty-five reviews were included. We provide an overview of the definitions of empathy, compassion and person-centred communication, outcome measures used, a synthesis of findings on the mechanisms and effectiveness of training and a summary of review recommendations.

CONCLUSIONS

For policy and practice, we advise the inclusion of empathic communication into the curriculum; longitudinal and sequenced learning; debriefing, targeted feedback, enabling self-reflection, deliberate practice, experiential learning; improving motivation by teaching the benefits of empathy and teaching sustainable empathy. Future research should involve patients in training and research and study the effect of targeting interventions at healthcare practitioners and patients.

The impact of theory of mind, stress and professional experience on empathy in Romanian community nurses-a cross-sectional study

BACKGROUND

High empathy levels in health professionals represent an important factor in patient satisfaction and compliance, reducing patient anxiety and pain, enhancing diagnostic and clinical results and strengthening patient empowerment. Our purpose was to determine empathy level and to identify which of the socioeconomic status (SES) and psychological factors were able to predict highest empathy levels in a Romanian sample of community nurses.

METHODS

Community nurses were invited in January-February 2023 to provide an answer to an online survey, using an advertisement in a professional network. 1580 participants voluntarily agreed to take part in this study, with a response rate of 85.8%. The survey included the Toronto Empathy Questionnaire, the Reading the Mind in the Eyes Test and socio-economic status items. A multivariate model for the prediction of belonging to the highest quartile of empathy as opposed to lowest quartile was constructed using SES and psychological variables as factors.

RESULTS

The mean (SD) empathy level was 49.1 (6.7), with 74.7% of participants over the threshold of high empathy level. In the multivariate analysis, predictors of belonging to the highest quartile of TEQ, as opposed to the lowest quartile were: low self-perceived stress level (OR = 2.098, 95%CI 1.362-3.231), higher experience as a community nurse (OR = 1.561, 95%CI 1.120-2.175) and higher levels of the theory of mind (OR = 1.158, 95%CI 1.118-1.199), when controlling for gender, age, relationship status, presence of children in families, education, and income.

CONCLUSIONS

Training programs targeting to increase emotional competences, reduce levels of stress and encourage personnel retention have the potential to increase the quality of community nursing in Romania.

Technology-based interactive communication simulation for Korean nurses: A randomized controlled repeated-measures design

BACKGROUND

Effective and standardized technology-based communication simulations addressing diverse clinical situations for novice nurses are limited.

OBJECTIVES

This study evaluated the efficacy of the Technology-based Interactive Communication Simulation for Nurses on communication competency (knowledge, self-efficacy, skills, and clarity), compassion, and assertiveness among novice nurses.

DESIGN

We used a randomized controlled repeated-measures design. Participants were randomly assigned to either the intervention (Technology-based Interactive Communication Simulation for Nurses) or attention control group and completed the assigned program, the questionnaire thrice (i.e., before, immediately after, and four weeks after the program), and the e-simulation twice (i.e., immediately after and four weeks after the program).

SETTINGS AND PARTICIPANTS

Korean nurses with six months to two years of experience recruited from five secondary and tertiary hospitals participated in the study at a private, quiet place of their choice.

METHODS

The intervention comprises two simulation cases across different formats: (1) an interactive communication simulation for various clinical situations followed by a tailored debriefing; and (2) a video showing a conflict between a nurse and caregiver and between nurses, followed by a self-reflection activity. Communication skills and clarity were also evaluated by raters. Data analyses included descriptive analyses, t-tests, chi-square tests, and a generalized estimating equation model.

RESULTS

In total, 142 nurses (73 in the intervention and 69 in the attention control groups) participated in the programs, and 128 participated through the four-week follow-up. Technology-based Interactive Communication Simulation for Nurses significantly improved communication knowledge and self-efficacy and compassion among novice nurses compared to the attention control program, and its effects were maintained for four weeks. The group difference in communication skills and clarity evaluated by the raters was also significant.

CONCLUSION

Technology-based Interactive Communication Simulation for Nurses is effective in enhancing the communication competence of novice nurses. Future studies should analyze assertiveness in Korean healthcare settings.

Impact of the Empathic Understanding of People and Type D Personality as the Correlates of Social Skills of Primary Health Care Nurses: A Cross-Sectional Study

Efficient functioning at work depends on social skills. The aim of this study was to assess the relationship among empathy, type D personality traits, and the level of social skills among Primary Health Care (PHC) nurses. A cross-sectional study was carried out involving 446 PHC nurses. In the multidimensional model, after taking into account disruptive variables (age, place of residence, postgraduate education and self-assessment of health), as in one-dimensional models, respondents with a higher level of empathic understanding of other people were found to have a higher level of social skills (b = 0.76; SE = 0.11; p < 0.001), while a lower level of social skills was observed among respondents with traits which are characteristic of type D personality (b = −11.86; SE = 2.28; p < 0.001). The results of the study show that personal predispositions, such as empathy or type D personality, may support or hinder the shaping of social skills of nurses. Therefore, it is essential to create an individualised approach when nurses are undergoing social skills training.