Perceptions of an evidence-based empathy mobile app in post-secondary education.

Cognitive empathy (also known as perspective-taking) is an important, teachable, skill. As part of a knowledge translation project, we identified a) interest in an evidence-based cognitive empathy mobile app and b) which faculties believe that cognitive empathy is important for their profession. Students (n = 638) and instructors/professors (n = 38) completed a university-wide survey. Participants in Education, Social Work, and the Health Sciences were among those most interested in the app. The majority of participants said that they would prefer for the app to be free or less than $3 for students. Most participants preferred a one-time payment option. Across 17 faculties, all but one had 60% or more of its sampled members say that cognitive empathy is important for their profession. Results illuminate perceptions of cognitive empathy instruction and technology. Results also provide insight into issues to consider when developing and implementing an educational communication app.

Canadian Hospital and Home Visiting Nurses' Attitudes Toward Families in Transitional Care: A Descriptive Comparative Study.

Despite the key role that hospital and home care nurses have in supporting family carers in transitional care, there is limited comparative information on their attitudes toward supporting family carers during care transitions. As part of a larger research project, we conducted a descriptive comparative study using a cross-sectional survey. Canadian nurses (105 hospital, 34 home visiting) completed a demographic questionnaire and the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) measurement tool. There were no statistically significant differences between hospital and home visiting nurses' attitudes, which were positive about including families in care. Nurses who reported having a workplace philosophy or general approach to the care of family held more positive attitudes toward families than those who did not. This is important because positive attitudes are often linked to better communication with family carers and thus, better patient and carer outcomes. To our knowledge, only one Canadian master's thesis has used this tool. Thus, this research furthers understanding of nurse attitudes within a Canadian context. Furthermore, this article adds to the literature by including suggestions for future research that are based in social psychological theories. Interdisciplinary knowledge can help pre- and postlicensure clinicians in advanced family nursing to better lever barriers and facilitators within family nursing practice.

Heart health whispering: A randomized, controlled pilot study to promote nursing student perspective-taking on carers' health risk behaviors.

BACKGROUND: Lifestyle counseling is described as a "major breakthrough" in the control of chronic diseases. Counseling can be challenging to nurses due their lack of motivation to counsel, hesitancy to appear non-judgmental, lack of empathy, and lack of time. Nurses voice their need for more training in counseling communication skills. Our main objective was to engage in ongoing development and testing of a promising Heart Health Whispering perspective-taking intervention on nursing students' clinical empathy, perceptual understanding, and client readiness to alter health risk behaviors. METHODS: In this randomized controlled pilot study, the full intervention (perspective-taking instructions, practice, and video-feedback) and partial intervention (video-feedback only) comprised 24 and 18 nursing students, respectively. Quantitative data were collected with a 10-item pre- and post-intervention clinical empathy tool, a one-item 'readiness to change' health risk behavior tool plus similarity ratings on students' empathic accuracy were calculated. Data were analyzed using Independent Samples t Tests and mixed model ANCOVA models. Students' and actors' evaluative responses toward the intervention phases were collected by handwritten notes, and analyzed using content analysis and constant comparison techniques. RESULTS: The main finding was that students in the full intervention group reported greater clinical empathy in the post versus baseline condition. Students underestimated their clinical empathy in comparison to carers' reports in the post-condition. In both intervention groups, carers reported more readiness to change in the post-condition. Carers identified favorable and unfavorable perceptions and outcomes of approaches taken by students. Students desired immediate and direct feedback after the video-dialogue and -tagging exercise. CONCLUSIONS: Heart Health Whispering is a promising intervention to help educators in basic and continuing education to bolster nurse confidence in empathic conversations on health risk behaviors. This intervention incorporates commonly used strategies to teach empathic communication along with a novel video-analysis application of a perspective-taking task. Student and carer actor comments highlighted the value in opportunities for students to engage in self-evaluation and practicing the empathic process of taking the client's perspective on health risk behaviors.

A randomized pragmatic feasibility trial to promote student perspective-taking on client physical activity level: a collaborative project.

BACKGROUND: Health-care practitioners have opportunities to talk with clients about unhealthy behaviors. How practitioners approach these conversations involves skill to be effective. Thus, teaching health-care students to communicate empathetically with clients should promote effective client-practitioner conversations about health behavior change. The primary objective of this pilot trial was to assess the feasibility, acceptability, and appropriateness of a theoretically informed intervention designed to improve perspective-taking. METHODS: For inclusion in this randomized mixed-methods parallel two-arm trial, participants needed to be a student at the investigators' Canadian university and have completed course content on behavior change communication. Using a 1:1 allocation ratio, participants in Respiratory, Physical, and Occupational Therapy; Nurse Practitioner; and Kinesiology programs were randomly assigned to full or partial intervention conditions. Full intervention participants completed a perspective-taking workshop and practiced perspective-taking prior to an in-lab dialogue with a client-actor (masked to condition) about physical activity. Partial intervention participants received the workshop after the dialogue. We assessed feasibility and appropriateness by comparing recruitment rates, protocol, and psychometric outcomes to criteria. We assessed acceptability (secondary outcome) by analyzing exit interviews. RESULTS: We screened and randomized 163 participants (82 = full intervention; 81 = partial intervention). We fell slightly short of our recruitment success criteria (10-15 participants per program) when 2/50 Occupational Therapy students participated. We met some but not all of our protocol criteria: Some full intervention participants did not practice perspective-taking before the dialogue, because they did not see anyone during the practice period or did not have a practice opportunity. Psychometric outcomes met the criteria, except for one measure that demonstrated ceiling effects and low reliability (Cronbach's alpha < .70). There were no adverse events related to participation. CONCLUSIONS: The intervention should be largely feasible, appropriate, and acceptable to deliver. We suggest changes that are large enough to warrant conducting another pilot study. We outline recommended improvements that are applicable to researchers and educators interested in recruitment, adherence to home practice, and online uptake of the intervention. TRIAL REGISTRATION: This trial was registered retrospectively on November 8, 2023, at https://clinicaltrials.gov/study/NCT06123507 .

Usability Testing of a Web-Based Empathy Training Portal: Mixed Methods Study.

BACKGROUND: The prepandemic period saw a rise in web-based teaching. However, web-based tools for teaching the essential clinical skill of cognitive empathy (also known as perspective taking) remain limited. More of these tools are needed and require testing for ease of use and understanding by students. OBJECTIVE: This study aimed to evaluate the usability of the In Your Shoes web-based empathy training portal application for students using quantitative and qualitative methods. METHODS: This 3-phase formative usability study used a mixed methods design. In mid-2021, we conducted a remote observation of student participants interacting with our portal application. Their qualitative reflections were captured, followed by data analysis and iterative design refinements of the application. Overall, 8 third- and fourth-year nursing students from an undergraduate baccalaureate program at a Canadian university, in the western province of Manitoba, were included in this study. Participants in phases 1 and 2 were remotely observed by 3 research personnel while engaged in predefined tasks. In phase 3, two student participants were asked to use the application as they liked in their own environments, after which a video-recorded exit interview with a think-aloud process was conducted as participants responded to the System Usability Scale. We calculated descriptive statistics and performed content analysis to analyze the results. RESULTS: This small study included 8 students with a range of technology skills. Usability themes were based on participants' comments on the application's appearance, content, navigation, and functionality. The biggest issues that participants experienced were with navigating the application's "tagging" features during video analysis and the length of educational material. We also observed variations in 2 participants' system usability scores in phase 3. This may be because of their different comfort levels with technology; however, additional research is required. We made iterative refinements to our prototype application (eg, added pop-up messages and provided a narrated video on the application's "tagging" function) based on participant feedback. CONCLUSIONS: With increasing engagement in web-based teaching, technology has become an essential medium for receiving health care education. We developed a novel prototype application as a supplemental classroom tool to foster students' self-directed learning of empathy. This study provided direction for refinements to optimize the usability of and satisfaction with this innovative application. Qualitative feedback revealed favorable input toward learning perspective taking place on the web and helpful recommendations for improving user experiences with the application. We could not fully assess the application's key functions owing to the COVID-19 protocols. Thus, our next step is to obtain feedback from a larger sample of student users, whose experiences performing "live" video capture, annotation, and analysis will be more authentic and wholesome with the refined application. We discuss our findings in relation to research on nursing education, perspective taking, and adaptive e-learning.

Rules of engagement: A content analysis of accepted and rejected marriage proposals.

Little research exists concerning the Western marriage proposal ritual, and rejected proposals are particularly understudied. The current research used the lens of life script theory to quantitatively and qualitatively analyze 374 first-person written accounts of accepted and rejected marriage proposals between men and women that were sampled from online forums. Rejected proposals were more likely than accepted proposals to violate the proposal script. Compared to accepted proposals, rejected proposals included fewer ritual elements and they often happened "off-time." Specifically, rejected proposals came earlier in the relationship, typically prior to the discussion of the topic of marriage by the couple, and rejected men sometimes proposed to "save" an unstable or abusive relationship that was headed toward dissolution. As with other important life transition events, audiences played an important role in many proposals. Rejected proposals were more likely to occur in public than accepted proposals, and when present, audience members often participated in the proposal by encouraging couples to follow the proposal script and by expressing dissatisfaction when the script was violated. Some audiences became hostile when the woman said "no." Also consistent with life script theory, couples evinced strong emotions during proposals, and confusion and anger were common emotional responses among rejected suitors. Indeed, 15% of rejected proposal accounts described intimate partner violence. Yet, about 30% of relationships continued after the rejection, sometimes for years. These and other novel results contribute to the science of close relationships, family psychology, life script theory, commitment, rejection, and social rituals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Friends-to-Lovers Pathway to Romance: Prevalent, Preferred, and Overlooked by Science.

There is more than one pathway to romance, but relationship science does not reflect this reality. Our research reveals that relationship initiation studies published in popular journals (Study 1) and cited in popular textbooks (Study 2) overwhelmingly focus on romance that sparks between strangers and largely overlook romance that develops between friends. This limited focus might be justified if friends-first initiation was rare or undesirable, but our research reveals the opposite. In a meta-analysis of seven samples of university students and crowdsourced adults (Study 3; N = 1,897), two thirds reported friends-first initiation, and friends-first initiation was the preferred method of initiation among university students (Study 4). These studies affirm that friends-first initiation is a prevalent and preferred method of romantic relationship initiation that has been overlooked by relationship science. We discuss possible reasons for this oversight and consider the implications for dominant theories of relationship initiation.

Are perspective-taking outcomes always positive? Challenges and mitigation strategies.

BACKGROUND: Engaging in perspective-taking often has positive outcomes for both healthcare providers and patients. Perspective-taking by healthcare providers has been linked to increased patient satisfaction and compliance, patients' positive perceptions of healthcare providers' interpersonal skills, and a reduction in judgmental attitudes toward individuals who engage in health-risk behaviors. The positive outcomes that are associated with perspective-taking are often highlighted in the literature. However, less discussed are the negative outcomes. AIM: This paper discusses the positive and negative outcomes associated with perspective-taking and presents potential methods for mitigating negative outcomes. CONCLUSION: When designing and implementing perspective-taking interventions, educators and researchers should consider potential negative intervention outcomes and strategies to attenuate these outcomes.

Registered Replication Report: Study 1 From Finkel, Rusbult, Kumashiro, & Hannon (2002).

Finkel, Rusbult, Kumashiro, and Hannon (2002, Study 1) demonstrated a causal link between subjective commitment to a relationship and how people responded to hypothetical betrayals of that relationship. Participants primed to think about their commitment to their partner (high commitment) reacted to the betrayals with reduced exit and neglect responses relative to those primed to think about their independence from their partner (low commitment). The priming manipulation did not affect constructive voice and loyalty responses. Although other studies have demonstrated a correlation between subjective commitment and responses to betrayal, this study provides the only experimental evidence that inducing changes to subjective commitment can causally affect forgiveness responses. This Registered Replication Report (RRR) meta-analytically combines the results of 16 new direct replications of the original study, all of which followed a standardized, vetted, and preregistered protocol. The results showed little effect of the priming manipulation on the forgiveness outcome measures, but it also did not observe an effect of priming on subjective commitment, so the manipulation did not work as it had in the original study. We discuss possible explanations for the discrepancy between the findings from this RRR and the original study.