The impact of educational interventions on the empathic concern of health professional students: A literature review.

This review aimed to identify programs that promote health professional students' empathic concern. Empathic concern is a key mediator of important outcomes for both patients and health professionals. However the empathic concern of health professional students tends to decline over the course of their studies. To date studies that have evaluated the impact of educational programs on empathic concern have not been reviewed. The databases ProQuest, CINAHL and Ovid were searched for studies that had evaluated educational programs for health professional students using a validated psychometric measure of empathic concern. Studies were graded using The Quality Assessment Tool for Quantitative Studies. Of 2977 identified studies, fifteen met inclusion criteria. Seven studies separately reported empathic concern scores. Four of the fifteen studies reported increased empathy scale scores after students took part in a program. Two studies received a strong quality rating, six a moderate rating and seven a weak rating. This review did not identify any studies that clearly demonstrated an increase in students' empathic concern after taking part in an educational program. Mindfulness based stress reduction, providing empathy content at each stage of a degree, programs that incorporate the film Wit, and Balint groups, may promote empathic concern. In light of the significant impact of health professionals' levels of empathic concern on outcomes for patients and health professionals, further robustly designed research using appropriate psychometric scales is needed to inform the development of education programs in this area.

Analysis of the Empathic Concern Subscale of the Emotional Response Questionnaire in a Study Evaluating the Impact of a 3D Cultural Simulation.

Abstract Background Empathic concern has been found to decline in health professional students. Few effective educational programs and a lack of validated scales are reported. Previous analysis of the Empathic Concern scale of the Emotional Response Questionnaire has reported both one and two latent constructs. Aim To evaluate the impact of simulation on nursing students' empathic concern and test the psychometric properties of the Empathic Concern scale. Methods The study used a one group pre-test post-test design with a convenience sample of 460 nursing students. Empathic concern was measured pre-post simulation with the Empathic Concern scale. Factor Analysis was undertaken to investigate the structure of the scale. Results There was a statistically significant increase in Empathic Concern scores between pre-simulation 5.57 (SD = 1.04) and post-simulation 6.10 (SD = 0.95). Factor analysis of the Empathic Concern scale identified one latent dimension. Conclusion Immersive simulation may promote empathic concern. The Empathic Concern scale measured a single latent construct in this cohort.

Measuring the impact of a 'point of view' disability simulation on nursing students' empathy using the Comprehensive State Empathy Scale.

BACKGROUND: Although empathy is an integral component of professional practice and person-centred care, a body of research has identified that vulnerable patients groups frequently experience healthcare that is less than optimal and often lacking in empathy. AIM: The aim of this study was to examine the impact of an immersive point-of-view simulation on nursing students' empathy towards people with an Acquired Brain Injury. SETTING AND PARTICIPANTS: A convenience sample of 390 nursing students from a cohort of 488 participated in the study, giving a response rate of 80%. Students undertook the simulation in pairs and were randomly allocated to the role of either a person with Acquired Brain Injury or a rehabilitation nurse. The simulated 'patients' wore a hemiparesis suit that replicated the experience of dysphasia, hemianopia and hemiparesis. DESIGN: Characteristics of the sample were summarised using descriptive statistics. A two-group pre-test post-test design was used to investigate the impact of the simulation using the Comprehensive State Empathy Scale. t-Tests were performed to analyse changes in empathy pre post and between simulated 'patients' and 'rehabilitation nurses'. RESULTS: On average, participants reported significantly higher mean empathy scores post simulation (3.75, SD=0.66) compared to pre simulation (3.38 SD=0.61); t (398)=10.33, p<0.001. However, this increase was higher for participants who assumed the role of a 'rehabilitation nurse' (mean=3.86, SD=0.62) than for those who took on the 'patient' role (mean=3.64, SD=0.68), p<0.001. CONCLUSION: The results from this study attest to the potential of point-of-view simulations to positively impact nursing students' empathy towards people with a disability. Research with other vulnerable patient groups, student cohorts and in other contexts would be beneficial in taking this work forward.

Development and psychometric testing of the satisfaction with Cultural Simulation Experience Scale.

Decreasing the numbers of adverse health events experienced by people from culturally diverse backgrounds rests, in part, on the ability of education providers to provide quality learning experiences that support nursing students in developing cultural competence, an essential professional attribute. This paper reports on the implementation and evaluation of an immersive 3D cultural empathy simulation. The Satisfaction with Cultural Simulation Experience Scale used in this study was adapted and validated as the first stage of this study. Exploratory factor analysis and confirmatory factor analysis were undertaken to investigate the psychometric properties of the scale using two randomly-split sub-samples. Cronbach's Alpha was used to examine internal consistency reliability. Descriptive statistics were used for analysis of mean satisfaction scores and qualitative comments to open-ended questions were analysed and coded. A purposive sample (n = 497) of second of nursing students participated in the study. The overall Cronbach's alpha for the scale was 0.95 and each subscale demonstrated high internal consistency: 0.92; 0.92; 0.72 respectively. The mean satisfaction score was 4.64 (SD 0.51) out of a maximum of 5 indicating a high level of participant satisfaction with the simulation. Three factors emerged from qualitative analysis: "Becoming culturally competent", "Learning from the debrief" and "Reflecting on practice". The cultural simulation was highly regarded by students. Psychometric testing of the Satisfaction with Cultural Simulation Experience Scale demonstrated that it is a reliable instrument. However, there is room for improvement and further testing in other contexts is therefore recommended.

Measuring the impact of a 3D simulation experience on nursing students' cultural empathy using a modified version of the Kiersma-Chen Empathy Scale.

AIMS AND OBJECTIVES: To determine the effect of immersive 3D cultural simulation on nursing students' empathy towards culturally and linguistically diverse patients. BACKGROUND: Accelerated globalisation has seen a significant increase in cultural diversity in most regions of the world over the past forty years. Clinical encounters that do not acknowledge cultural factors contribute to adverse patient outcomes and health care inequities for culturally and linguistically diverse people. Cultural empathy is an antecedent to cultural competence. Thus, appropriate educational strategies are needed to enhance nursing students' cultural empathy and the capacity to deliver culturally competent care. DESIGN: A one-group pretest, post-test design was used for this study. The simulation exposed students to an unfolding scene in a hospital ward of a developing county. METHODS: A convenience sample of second-year undergraduate nursing students (n = 460) from a semi-metropolitan university in Australia were recruited for the study. Characteristics of the sample were summarised using descriptive statistics. T-tests were performed to analyse the differences between pre- and post simulation empathy scores using an eight item modified version of the Kiersma-Chen Empathy Scale. RESULTS: Students' empathy towards culturally and linguistically diverse patients significantly improved after exposure to the 3D simulation experience. The mean scores for the Perspective Taking and Valuing Affective Empathy subscales also increased significantly postsimulation. CONCLUSIONS: The immersive 3D simulation had a positive impact on nursing students' empathy levels in regards to culturally and linguistically diverse groups. Research with other cohorts and in other contexts is required to further explore the impact of this educational approach. RELEVANCE TO CLINICAL PRACTICE: Immersive cultural simulation experiences offer opportunities to enhance the cultural empathy of nursing students. This may in turn have a positive impact on their cultural competence and consequently the quality of care they provide to culturally and linguistically diverse patients.

Psychiatric status of asylum seeker families held for a protracted period in a remote detention centre in Australia.

OBJECTIVE: To document the psychiatric status of a near complete sample of children and their families from one ethnic group held for an extended period of time in a remote immigration detention facility in Australia. METHOD: Structured psychiatric interviews were administered by three same-language speaking psychologists by phone to assess the lifetime and current psychiatric disorders among 10 families (14 adults and 20 children) held in immigration detention for more than two years. RESULTS: All adults and children met diagnostic criteria for at least one current psychiatric disorder with 26 disorders identified among 14 adults, and 52 disorders among 20 children. Retrospective comparisons indicated that adults displayed a threefold and children a tenfold increase in psychiatric disorder subsequent to detention. Exposure to trauma within detention was commonplace. All adults and the majority of children were regularly distressed by sudden and upsetting memories about detention, intrusive images of events that had occurred, and feelings of sadness and hopelessness. The majority of parents felt they were no longer able to care for, support, or control their children. CONCLUSIONS: Detention appears to be injurious to the mental health of asylum seekers. IMPLICATIONS: The level of exposure to violence and the high level of mental illness identified among detained families provides a warning to policy makers about the potentially damaging effects of prolonged detention on asylum seekers. In their attempt to manage the international asylum crisis, it is important that Western countries do not inadvertently implement policies that cause further harm.