Empathic decline and training in nursing students

The impact of community engaged healthcare education on undergraduate students' empathy and their views towards social accountability; a mixed methods systematic review

BACKGROUND

Many non-communicable diseases are rooted in social factors that determine health outcomes. Complex topics such as the social determinants of health are difficult to teach through traditional didactic methods. Since the introduction of the social accountability of medical schools' framework in 1995 by the World Health Organisation, healthcare education institutions are encouraged to shift their traditional education models towards a socially accountable approach. Community engagement can facilitate a deeper understanding of health inequity, barriers to health care, and the social determinants of health whilst enabling institutions to meet their obligation to the communities they serve. This systematic review aimed to answer the following question: ''What is the impact of community engaged healthcare education on undergraduate healthcare students' empathy and their views towards social accountability?''.

METHODS

This is a mixed-methods systematic review. The protocol was registered with PROSPERO (CRD42022306181). The following databases were searched: Scopus, MEDLINE, Embase, CINAHL, ERIC, BEI for primary research studies published from 1995 to September 2024. Grey literature was also searched via EThOS and Google. Studies recruiting undergraduate students of regulated healthcare professions in countries of very high development were included. A convergent integrated approach to synthesis was followed.

RESULTS

Out of the 19,590 papers yielded from the literature search, 76 met the inclusion criteria and were included in the review. The following subthemes were generated under three overarching themes: Social accountability (advocacy for action; giving back to the community; bigger picture-identifying social determinants of health and barriers to healthcare; barriers to social accountability), Empathy (humanise community members-everybody has a story; overcome bias and challenge attitudes, assumptions and stereotypes; cultural competence and sensitivity; empathetic communication and interpersonal skills; feeling sympathy and sadness), and Shaping the future workforce (future professional demeanour; professional interests; interprofessional education and collaboration).

CONCLUSIONS

Community engaged education can help students better understand community needs, social determinants of health, improve empathy and cultural sensitivity, and build advocacy for social justice and change.

Relationships among nursing students’ self-concept clarity, meaning in life, emotion regulation ability and depression: Testing a moderated mediation model

Objective

Self-concept clarity as an inducing factor of depressive symptoms has been confirmed in previous studies. However, little is known about how and when it induces depressive symptoms in nursing students. The study is to examine the potential mediating role of meaning in life and the moderation of emotion regulation ability in the association between self-concept clarity and depressive symptoms among college nursing students.

Materials and Methods

A sample of 488 college nursing students participated in this study Southeast China. The Chinese adaptations of Self-concept clarity Scale, Sense of life Scale, Depression scale, Emotion regulation scale were used. Mediation and moderation analyses were carried out in the SPSS macro PROCESS.

Results

Self-concept clarity was significantly and negatively associated with depression in nursing students, meaning in life had a partial mediating effect on the relationship between self-concept clarity and depression. Furthermore, emotion regulation ability moderated the direct effect of self-concept clarity on depression.

Conclusion

The findings enrich the knowledge of the mediating and moderating mechanisms to explain the association between self-concept clarity and depression in nursing students. There have been proposed interventions concerning increasing self-concept clarity, meaning in life and emotion regulation ability training which could help help reduce the depression among nursing students.

The effect of affective learning on alexithymia, empathy, and attitude toward disabled persons in nursing students: A randomized controlled study

PURPOSE

To evaluate the effect of affective learning on alexithymia, empathy, and attitude toward disabled persons in nursing students.

DESIGN AND METHODS

This prospective, randomized, controlled trial study was implemented among 70 nursing students. Based on transformative learning theory, the affective learning method was applied to the intervention group. Toronto Alexithymia Scale (TAS), Empathic Tendency Scale (ETS), and Attitudes Toward Disabled Person Scale (ATDPS) were administered to both groups.

RESULTS

The intervention group showed a statistically and significantly lower score at TAS and higher score at ATDPS compared to the control group, whereas no statistically significant difference was found in ETS score.

PRACTICE IMPLICATIONS

Affective learning methods could be implemented in the nursing course for improving students' attitude toward disabled persons, and reducing alexithymia.

Variabilidad empática en estudiantes de odontología. Consecuencias aún no entendidas en América Latina

Introducción. La empatía es un atributo que permite a los odontólogos establecer una relación intersubjetiva con sus pacientes, lo que contribuye a un tratamiento exitoso, entre otros beneficios. Objetivo. Determinar si hay variabilidad en los niveles de empatía entre dos poblaciones de estudiantes de odontología y describir teóricamente las implicaciones generales de esta variabilidad en estrategias de intervención. Materiales y métodos. Estudio exploratorio transversal. La población de estudio consistió de estudiantes de odontología de 1er a 5to año de la Universidad Santiago de Cali, Colombia (n=610; N=647) y la Universidad San Sebastián, Chile (n=535; N=800). En ambos grupos, la empatía se midió con la Escala de Empatía de Jefferson (Versión S). Para el análisis de los datos se utilizó estadística descriptiva (media y desviación estándar). La consistencia interna de los datos se estimó mediante el alfa de Cronbach y el coeficiente de correlación intraclase. Se realizó un análisis de varianza factorial: tres factores estudiados: Universidad (U), Curso (C) y Sexo (S). El nivel de significancia estadística utilizado fue de α≤ 0.05 y β≤ 0.20. Resultados. Se observaron diferencias en el nivel de empatía y algunas de sus tres dimensiones entre los estudiantes de ambas universidades y entre los cursos (1er-5to año). No se observaron diferencias entre sexos. Conclusiones. Existe variabilidad en los niveles de empatía entre los estudiantes de ambas universidades. Para aumentar los niveles de empatía en esta población en Latinoamérica se requiere la implementación de estrategias específicas de intervención empática en cada programa de odontología ofrecido en la región.