Teaching Empathy to Nurse Practitioner Students Using Simulation and Theatre

Purpose: Empathy is a cognitive and affective process that enables the development of concern and profound understanding of the client’s world while the client is present (Santamaria-Garcia, et al., 2017). The purpose of this project is to improve cognitive and emotional empathy regarding adolescent anorexia, depression and suicide within a family context using human simulation in a nursing simulation lab and “The Pill,” a professional theatre production adapted to fit health care providers in critical scenes depicting live theatre episodes of reaching out for health care. Cognitive and emotional empathy enhancement will be used as a conduit to meeting the course objectives to 1) integrate findings from the individual patient within a family, cultural and community context into the treatment plans for adolescents with nutritional disorders and depression 2) identify symptoms and situations that warrant further referral and involvement of the health care team.

Methods: A pre-post design methodology will be implemented using a modified Kiersma-Chen Empathy Scale (KCES) (2015) previously validated for use on nursing and pharmacy students in various cultural settings (Everson, et al., 2015). Fifty-eight doctor (58) of nursing practice students will be immersed in evidence-based simulation activities to promote an understanding of the patient and family dynamics related to adolescent depression and nutritional disorders. The training will consist of a progression of activities, unfolding scenes, and simulation teaching components using the theoretical frameworks from the NLN Jeffries Simulation Theory (Jeffries, 2016) and International Nurses Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice (INACSL, 2015).

The intervention consists of planned evidence-based simulation activities: 1) completion a pre-assignment and KCES 2) participation in a clinical interview of a standardized patient in a simulated exam room environment 3) live broadcast of this clinical interview to all student participants, 4) joint debriefing session with the simulation coordinator and psychiatric nurse practitioner facilitator on using empathy in the clinical interview 5) using rapid repeat of the training in an unfolding scenario through theatrical play where the standardized patient and the nurse practitioner student partake in the play within a family scenario revealing the family dynamics to the audience 6) interdisciplinary debriefing with a collaborate of facilitators (simulation coordinator, family nurse practitioner, psychiatric nurse practitioner, dietitian and pharmacist) 7) post-test utilization of the KCES and post-assignment incorporating communication effectiveness and course objectives.

Results: The project will be implemented in August 2019. The results will be evaluated using comparative analysis of pre and post formative assessments based on course objectives and a modified Kiersma-Chen Empathy Scale.

Conclusion: Human simulation and theatre immerse nurse practitioner students in an emotional and life-like experience, a cognitive and emotional process that may enhance emotional empathy and improve understanding of the intricate nature of the depressed, anorexic adolescent within the family dynamics within which they live, and may contribute to improved patient outcomes.