Kristen Hamblin and Gaye Ray, College of Nursing
Introduction
Empathy is an essential characteristic in nursing. In fact, the skill of empathy, the ability to understand the feelings or situation of another, is of paramount importance to the nurse-patient relationship. Additionally, empathetic interactions often lead to increased patient satisfaction, compliance, and overall quality of life. Empathetic nurses are more able to identify patient needs and provide high quality care and service.
Ward, Schaal, and Hojat (2012) define empathy as a cognitive attribute, rather than an emotional one. They define empathy as the ability to understand patients’ experiences and perspectives, communicate this understanding, and the intention to then help others. They suggest that students can develop empathy through a cognitive process. Therefore, these processes could be incorporated into nursing curriculum.
Unfortunately, however, Ward et al. (2012) have shown that empathy in nursing students declines over time throughout nursing school with increased patient contact. To enhance the nurse-patient relationship and provide safe, quality care, nurses must not only provide competent health care but also increase in empathy for their patients. Furthermore, nurse educators should focus their efforts on methods to develop enduring empathy in nursing students.
One population that nurses may not understand is that of individuals living in poverty. A poverty simulation gives students the opportunity to briefly experience living in poverty. In this research pilot study, Professor Ray and I examined the impact of a poverty simulation on nursing students’ empathy.
Methodology
The Global and Public Health Nursing course recently implemented The Missouri Community Action Poverty Simulation as part of its curriculum. The simulation takes place over three hours and involves up to 25 volunteers and 80 participants. During the simulation, each participant is given an identity as a member of a diversely configured family living in poverty. The participants are required to provide for the basic needs of the family during four 15-minute simulated weeks. In order to study the change of empathy in nursing students before and after this simulation, we invited students enrolled in the course during Fall 2013 to participate (n=51). We measured the participants’ empathy before and after the poverty simulation using the Jefferson Scale of Physician Empathy adapted to health profession students (JSE-HPS version). We identified the JSE-HPS from the literature as a Likert type self-report survey. The JSEHPS has internal consistency with a Cronbach’s coefficient of 0.78.
Results
After data collection, we submitted the completed surveys to the Center for Research in Medical Education and Health Care who calculated the descriptive statistics and performed a paired t-test to identify change in empathy. We found a statistically significant increase in empathy (p=0.02) after participation in the simulation.
Discussion
We found that participation in a poverty simulation does increase empathy in nursing students. This is important, as we discovered that there are indeed activities that can foster the development in empathy in nursing students. As a pilot study, there were several limitations of the study. First, we had a limited sample, as we only invited students enrolled in the Public and Global Health course to participate. Further research implications include a larger, multi-site study. Additionally, we only administered one post-test to the participants immediately after the simulation. A longitudinal study to track empathy over a longer period would be beneficial to determine long-term effects of the simulation.
Conclusion
Through this pilot study, Professor Ray and I found that participation in a poverty simulation increases empathy in nursing students. This is exciting for us nurses because we know now that there are activities that foster the development of empathy that we can incorporate into our curriculum. This is important because as we nursing students develop empathy in our nursing education, we will be better prepared to fulfill BYU’s mission which is to “go forth and serve” throughout our careers.