“Suiting Up” to Enhance Empathy Toward Aging: A Randomized Controlled Study

Abstract

Background: Healthcare professionals who have a positive attitude and who are more empathetic toward older adults are in a better position to deliver quality healthcare. This study examines the impact of using an aging simulation suit on undergraduate pharmacy students' empathy levels. Methods: One hundred and twenty first-year students enrolled in the Bachelor of Pharmacy course were randomized to either a medication review polypharmacy workshop (control) or an immersive aging simulation suit and medication review polypharmacy workshop (intervention). Intervention participants donned the aging suit and performed a series of tasks, including walking up a flight of stairs and filling up a form to simulate the physical limitations experienced by an older adult. The workshop was delivered at week 10 of semester. Both groups also completed a medication review polypharmacy workshop at week 12 of semester. The primary outcome was a measurement of change on the Jefferson Empathy Scale-Healthcare Professional Questionnaire among both groups at week 12 of semester. Secondary outcomes include the longitudinal impact of intervention after 3 months of the workshop and perceptions on learning. Results: The use of a simulation suit did not increase participants' self-rated empathy compared to control. However, the suit enhanced the ability of participants to understand the physical limitations and visual issues associated with aging. Participants also felt that it enhanced their health advocacy, as it taught them the importance of listening, patience and respect for older adults. Conclusion: The use of an immersive aging suit can be a useful adjunctive tool to help enhance students' understanding of the physical limitations and visual limitations of aging. Further research is needed to understand how these limitations affect other healthcare students. Trial Registration: ClinicalTrials.gov identifier: NCT04133727.

“Aging Means to Me… That I Feel Lonely More Often”? An Experimental Study on the Effects of Age Simulation Regarding Views on Aging

“…Apart from that, the explicit inclusion of more diverse middle-aged to even young-old adults instead of a young student population and the design combining established questionnaires with validated geriatric assessments with and without the suit are major strengths of our study. We further intended to overcome the limitation of the usually very short time frames for the simulation experiences (i.e., 10 min with the suit; Lee and Teh, 2020 ). By assessing background characteristics such as health status and BMI and being able to draw on the performance data with and without the suit, we were able to provide a more comprehensive picture.…”

“…Cheng et al (2020) used a control group wearing placebo clothes (i.e., a white wig) and found increases in positive attitudes (KAOP) in both groups, but no group differences favoring the ASS group. Similarly, Lee and Teh (2020) did not find group differences between students in the ASS intervention group and control group (polypharmacy workshop) regarding self-rated empathy levels (measure: Jefferson Scale of Empathy-Health Profession Students; Fields et al, 2011).…”

“…Although both reviews concluded that such ASS interventions might be useful, for example to promote person-centered care, they also found large heterogeneity in the methodological quality among included studies. For example, the three randomized controlled trials that have been published until now were all among student populations and yielded mixed results ( Mohamed et al, 2017 ; Cheng et al, 2020 ; Lee and Teh, 2020 ). Mohamed et al (2017) reported that students who participated in an ASS intervention showed increased knowledge regarding typical changes associated with aging, less negative attitudes, but no significantly increased positive attitudes (measure: Kogan’s Attittudes Toward Older People Scale; KAOP; Kogan, 1961 ) in comparison to a control group that received a lecture on age-related changes.…”

Designing a Randomized Trial with an Age Simulation Suit—Representing People with Health Impairments

“…The choice of full or low weight GERT is allocated randomly in a ratio of 30 to 30 participants, whereas the participants are not informed of that fact. Thus, in comparison to, for example, Reference [ 20 ], participants are not aware if they are in the intervention or control group. By giving the control group a version of GERT with low weight, measuring effects of a behavioral expectation that might unintentionally be suggested by wearing the suit is avoided.…”

“…Focusing on increasing empathy for the elderly, Lee and Teh conduct a randomized controlled study with a homogeneous group of 120 pharmacy students. Here, the intervention group is equipped with an age simulation suit and asked to perform activities of daily life, for example, sitting down on a sofa and stand up again, combing their own hair or picking up a piece of paper [ 20 ]. These studies predominately use subjective assessment and self-assessment as scientific methodology.…”