Abstract
Empathy is regarded as essential to the development of a therapeutic relationship between a health professional and a patient, and has been associated with improved patient outcomes. Because of this, empathy education is increasingly being included in curriculums for health professionals, including nurses and doctors. Within the literature, little consideration appears to have been given to exploring experiences of individuals that have participated in empathy interventions.
The aim of this integrative review was to explore the perceptions and experiences of nursing and medical students that have participated in empathy interventions, in order to determine the likely core elements of empathy education. An integrative review was carried out utilising Whittemore and Knafl (2005) framework. The literature search was conducted in the following databases; Medline, Scopus, Cochrane and Web of Science. Using the PICo framework, the following keywords were generated; "nursing students", "undergraduate nurses", "medical students", "student nurses", "empathy education", "empathy intervention", "empathy teaching", "experience(s)" and "perception(s)". 11 relevant articles were selected and underwent the quality appraisal process using Joanna Briggs Institute validated tools. Following this process, ten articles remained for data analysis. From the analysis, four themes were identified; Making it real; Learning skills; Learning about self; The role of the facilitator.
The findings highlighted aspects of empathy education that had a positive impact on participants, and aspects that needed improving. The concept of making the intervention seem "real" appeared to be important in the fostering of empathy. A variety of skills such as communication and relational skills were reported as being acquired from the interventions, as well as learning about self through the practice of self-reflection, which is thought to facilitate the development of empathy. Finally, the role of the facilitator in ensuring the intervention provided benefits to all participants, became evident as the experiences of participants were explored. Analysis of these themes revealed that likely core elements of empathy education include; integration of the intervention with human interaction or dialogue, the process of reflection and debriefing, and the implementation of the intervention alongside or after clinical placement. Including these in empathy interventions could foster and develop empathy for nursing and medical students, in order to achieve therapeutic relationships and improve patient outcomes.