An Immersive Virtual Reality Simulation Scenario to Improve Empathy in Nursing Students

Empathy is essential in nursing practice and can be taught throughout nursing curriculum using a variety of methods including clinical experiences, in-person simulation, virtual reality, and didactic lecture. Empathy can also change over time, often decreasing the longer nurses practice. A cohort of upper-level nursing students viewed a short immersive virtual reality simulation as part of routine curriculum and completed the Toronto Empathy Questionnaire before viewing (time 1), 2 weeks later (time 2), and, for a small cohort, several months later (time 3). The sample included 110 undergraduate nursing students. There were no improvements in Toronto Empathy Questionnaire scores from time 1 to time 2. There was no improvement from time 1 to time 3 for the cohort who completed the Toronto Empathy Questionnaire three times. There were no significant differences in Toronto Empathy Questionnaire scores between cohorts for any measurement times. Total mean empathy scores were comparatively high in this study and did not decline over time. Although this virtual reality simulation scenario appears to have protected against decline in empathy, it may have been insufficient to foster an increase in empathy scores. Empathic training needs to be immersed throughout their nursing education in both didactic and clinical settings.

Helpful and Hurtful Empathy: How the Interplay of Empathy, Shame, and Anger Predicts Responses to Hypothetical Rape Disclosures

Responses to rape victims, although often helpful, can be hurtful and hinder victims' health and recovery. Adopting a multidimensional approach to dispositional empathy, this research investigated how different subfacets of empathy predict responses to hypothetical rape victims. Before reading a sexual assault scenario, 282 participants completed measures of cognitive and emotional empathy. Participants' subsequent emotional arousal was measured by self-report, as were their intentions to help, avoid, or blame the victim. A path model demonstrated that dispositional empathy predicted behavioral intentions toward hypothetical rape victims by altering their vulnerability to experience shame or anger. People who tended to feel personal distress were more likely to mirror rape victims' assumed shame. Due to its antisocial nature, experiencing shame, in turn, led to hurtful behaviors such as blaming or distancing oneself from the victim. On the other hand, people who tended to feel empathic concern were more likely to feel anger on behalf of the victim following a rape disclosure. Anger is a motivating force for action and promotes helping behavior. A second study demonstrated that these results appear unique to rape disclosure, namely, participants reactions to nonsexual assault were unsuccessfully captured by this model. Understanding how empathetic arousal of shame can lead to hurtful intentions toward rape victims has important implications for future interventions: Programs that draw attention to the shame or humiliation experienced by rape victims may do more harm than good. For instance, some anti-rape campaigns portray pictures of women covering their faces. These campaigns, however well intentioned, may discourage people from helping victims because they may evoke feelings of shame in the perceiver. On the other hand, societal movements, such as the #Metoo movement, may be particularly effective by reducing the shame surrounding sexual assault and promote helpful behaviors.

Empathy in MedicineCultivating an Empathetic Professional Identity in Osteopathic Medical Students Through Service Learning: A Qualitative Analysis of Reflective Essays

Context

The role of professional identity development has been established as a significant element of the "hidden curriculum" in medical education. While most programs do not contain explicit instruction on that topic, service learning initiatives are a popular trend in medical education that offer medical students early clinical experience and an opportunity to develop professional identity. Through intentional reflective practices, service learning can also promote empathy development, a critical component missing from current models.

Objective

To determine the role of service learning participation on the development of empathy and professional identity among osteopathic medical students.

Methods

Using a grounded theory method, the authors analyzed reflective essays from students who voluntarily participated in a service learning project that provided medical care to patients who are homeless. Essays were completed within 1 week of volunteer experience.

Results

The authors collected and analyzed 64 reflective essays from 55 students in this study. A review of the 64 texts yielded 5 coding domains and several subdomains. The codes revealed 4 major themes: (1) incoming attitudes, (2) transformative experiences, (3) empathy development, and (4) professional identity formation.

Conclusions

Structured service learning experiences provide students with an opportunity to develop an empathetic professional identity in the preclinical stage of medical education. This form of volunteer service is a transformative experience that challenges students' incoming perceptions and leads to the development of both empathy and professional identity.

The risk of empathy: longitudinal associations between empathy and burnout

OBJECTIVE

Prior research on the relation between empathy and burnout in social professions appears to be inconsistent. Whereas some studies have claimed that empathy functions as a buffer against burnout, others have argued that empathy contributes to the development of burnout. One explanation for this disparity may be methodological as most studies have relied on cross-sectional single-measure designs. To examine their cross-sectional and longitudinal associations, the present study analyzed cross-lagged data of several measures of empathy and burnout.

DESIGN

Data from two longitudinal studies with three to twelve months between measurements were analyzed. The samples contained 172 nursing students and 186 nurses, respectively.

MAIN OUTCOME MEASURES

Empathy was assessed using the Interpersonal Reactivity Index, the Toronto Empathy Questionnaire, the Geneva Emotion Recognition Test, and the Social Mindfulness Test Paradigm. Burnout was assessed using the Maslach Burnout Inventory, the Irritation Scale, and the Copenhagen Burnout Inventory.

RESULTS

Results showed significant cross-sectional correlations between the questionnaire measures of empathy and burnout. However, there was insufficient support for the cross-lagged associations.

CONCLUSIONS

Associations between empathy and burnout may be attributed to the methodological limitations of cross-sectional designs. However, the influence of potential moderators is discussed as a promising direction of future research.