Does narrative medicine education improve nursing students’ empathic abilities and academic achievement? A randomised controlled trial

Yang, Na; Xiao, Han; Cao, Yanshuo; Li, Shiyue; Yan, Hong; Wang, Yifang

doi:10.1177/0300060518781476

Cited by 50 publications

(46 citation statements)

References 38 publications

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“…These findings are in agreement with the study of Heidke et al,37 which revealed that incorporation of recorded health-care consumers’ interviews in a first-year nursing course significantly improved empathy in students. In line with recent studies highlighting the efficacy of experiential learning in empathy-competence acquisition,27,30,46–50 our results indicate moderate levels of empathy among nursing students at baseline, which had significantly improved, after intervention, as noted by other similar studies 23,41,46,49–51…”

Section: Discussionsupporting

confidence: 93%

<p>Effect of expert-patient teaching on empathy in nursing students: a randomized controlled trial</p>

Ferri¹,

Rovesti²,

Padula³

et al. 2019

PRBM

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Background: Empathy is a relevant clinical competence for nursing students. Involvement of expert patients in nursing education could help students develop their innate capacity to empathize. Objective: To evaluate the effect of expert-patient teaching on empathy development in nursing students. Methods: This randomized controlled trial was conducted among 144 first-year undergraduate nursing students divided into two equal groups. In the experimental group, the educational intervention consisted of a seminar focused on empathy, followed by a presentation on expert-patient function. Subsequently, each student participated in two interactive meetings with nursing teacher and expert patient. At the end, the nursing teacher encouraged students to reflect on this experience. In the control group, students only attended a similar seminar focused on empathy and afterward participated in two interactive meetings with a nursing teacher to reflect on this topic without expert-patient involvement. Before (T0) and after (T1) the training intervention, the Balanced Emotional Empathy Scale, Jefferson Scale of Empathy — Health Professions Student (JSE-HPS), and a short demographic questionnaire were administered to the two student groups to measure their empathy levels. The study was approved by the Local Ethics Committee of Area Vasta Emilia Nord (protocol 1763, May 11, 2017). Data were statistically analyzed. Results: We found a statistically significant difference between mean scores at T0 and T1 in both scales in the experimental group. Male students, who presented significantly lower levels of empathy at baseline in comparison with females, showed increased in empathy after training on the the Balanced Emotional Empathy Scale in both the experimental and control groups. Conclusion: The present study highlights that involvement of expert patients in teaching is effective in improving empathy levels in both male and female nursing students. Expert-patient teaching can be a promising nursing-education modality for developing empathy.

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Section: Discussionsupporting

confidence: 93%

<p>Effect of expert-patient teaching on empathy in nursing students: a randomized controlled trial</p>

Ferri¹,

Rovesti²,

Padula³

et al. 2019

PRBM

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“… 23 28 30 32 34–38 40 42 47 49 51 52 Thirteen were carried out in the USA and Canada, 29 32–34 40–43 45 46 48 50 seven in Europe, 23 30 36–38 47 51 three in Iran 35 39 49 and one each in Australia, 31 Ghana 28 and China. 52 Fourteen studies provided a definition of empathy. 30 32 34–37 40 43–47 51 52 …”

Section: Resultsmentioning

confidence: 99%

Assessing the effect of empathy-enhancing interventions in health education and training: a systematic review of randomised controlled trials

et al. 2020

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ObjectiveTo estimate the effect of empathy interventions in health education and training from randomised controlled trials (RCTs).MethodsMEDLINE, PsycINFO, EMBASE, CINAHL and Cochrane databases were searched from inception to June 2019 for RCTs investigating the effect of empathy-enhancing interventions in medical and healthcare students and professionals. Studies measuring any aspect of ‘clinical empathy’ as a primary or secondary outcome were included. Two reviewers extracted data and assessed the risk of bias of eligible studies using the Cochrane Risk of Bias Tool. Random effects meta-analyses of the impact of empathy training on participants’ empathy levels were performed.ResultsTwenty-six trials were included, with 22 providing adequate data for meta-analysis. An overall moderate effect on participant empathy postintervention (standardised mean difference 0.52, 95% CI 0.36 to 0.67) was found. Heterogeneity across trial results was substantial (I2=63%). Data on sustainability of effect was provided by 11 trials and found a moderate effect size for improved empathy up until 12 weeks (0.69, 95% CI 0.23 to 1.15), and a small but statistically significant effect size for sustainability at 12 weeks and beyond (standardised mean difference 0.34, 95% CI 0.11 to 0.57). In total, 15 studies were considered to be either unclear or high risk of bias. The quality of evidence of included studies was low.ConclusionFindings suggest that empathy-enhancing interventions can be effective at cultivating and sustaining empathy with intervention specifics contributing to effectiveness. This review focuses on an important, growing area of medical education and provides guidance to those looking to develop effective interventions to enhance empathy in the healthcare setting. Further high-quality trials are needed that include patient-led outcome assessments and further evaluate the long-term sustainability of empathy training.Protocol registration numberPROSPERO (CRD42019126843).

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“…Of quantitative programmes deemed as well described, six reported high satisfaction49 51 52 63 69 84 89 while modest and positive but not statistically significant impacts were reported on: pedagogical skills (n=2),38 85 relevance to professional work (n=1),63 resilience and burnout detection/mitigation (n=1)22 70 and confidence/increased sense of personal accomplishment (n=2) 22 38 70. Programmes that reported statistically significant programmatic impacts examined increased empathy (n=3),22 55 70 82 and increased perspective-taking/reflection (n=1) 22 70…”

Section: Resultsmentioning

confidence: 99%

“…During the second screening stage, we read the full texts of records, identifying a further 109 records to exclude due to our discovering on full-text review that they did not meet our established eligibility criteria (figure 1). Following the full-text screening, 61 records qualified for review 15 22 33–89. However, we discovered that several qualifying records addressed identical NM programming efforts at the same institution: that is, 12 records15 22 41 42 44–48 52 70 84 represented 6 programmes.…”

Section: Methodsmentioning

confidence: 99%

Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019

et al. 2020

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ObjectivesNarrative medicine (NM) incorporates stories into health sciences paradigms as fundamental aspects of the human experience. The aim of this systematic review is to answer the research question: how effective is the implementation and evaluation of NM programmes in academic medicine and health sciences? We documented objectives, content and evaluation outcomes of NM programming to provide recommendations for future narrative-based education.MethodsWe conducted a systematic review of literature published through 2019 using five major databases: PubMed, Embase, PsycINFO, ERIC and MedEdPORTAL. Eligible NM programming included textual analysis/close reading of published literature and creative/reflective writing. Qualifying participants comprised individuals from academic medicine and health sciences disciplines. We reviewed and categorised programme goals, content and evaluation activities to assess participant satisfaction and programme efficacy. Two members of the research team assessed the risk of bias, independently screening records via a two-round, iterative process to reach consensus on eligibility.ResultsOf 1569 original citations identified, we selected 55 unique programmes (described in 61 records). In all, 41 (75%) programmes reported a form of evaluation; evaluation methods lacked consistency. Twenty-two programmes used quantitative evaluation (13 well described), and 33 programmes used qualitative evaluation (27 well described). Well-described quantitative evaluations relied on 32 different measures (7 validated) and showed evidence of high participant satisfaction and pre-post improvement in competencies such as relationship-building, empathy, confidence/personal accomplishment, pedagogical skills and clinical skills. An average of 88.3% of participants agreed or strongly agreed that the programme had positive outcomes. Qualitative evaluation identified high participant satisfaction and improvement in competencies such as relationship-building, empathy, perspective-taking/reflection, resilience and burnout detection/mitigation, confidence/personal accomplishment, narrative competence, and ethical inquiry.ConclusionEvaluation suggests that NM programming leads to high participant satisfaction and positive outcomes across various competencies. We suggest best practices and innovative future directions for programme implementation and evaluation.

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Does narrative medicine education improve nursing students’ empathic abilities and academic achievement? A randomised controlled trial

Cited by 50 publications

References 38 publications

<p>Effect of expert-patient teaching on empathy in nursing students: a randomized controlled trial</p>

<p>Effect of expert-patient teaching on empathy in nursing students: a randomized controlled trial</p>

Assessing the effect of empathy-enhancing interventions in health education and training: a systematic review of randomised controlled trials

Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019

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