A growing body of research has demonstrated the effectiveness of authentic simulation experiences for enhancing learners’ empathy (Bearman, Palermo, NutriDiet & Williams, 2015). Indeed, evidence from four randomised controlled trials has demonstrated that experiential simulations where learners are asked to ‘literally stand in the patient’s shoes’ appear to be the most effective approach for teaching empathy (Bosse et al., 2012; Bunn and Terpstra, 2009; Daeppen et al., 2012; Henry et al., 2011). These educational initiatives, which we refer to as ‘point-of-view’ simulations (Levett-Jones et al, 2018), create a unique vantage point from which learners can see the world through the eyes of another person in order to gain new insights into their feelings, perspectives, needs and experiences. As Lee (1960, p. 36) wrote in To Kill a Mockingbird, ‘You never really understand a person until you consider things from his point of view … until you climb into his skin and walk around in it’. The point-of-view simulation approach introduces learners to the feelings and perspectives of patients, but through the debriefing and reflective thinking activities that follow, these understandings can be used to influence behavioural intentions and the empathetic behaviours expected of healthcare professionals.
The foci of the empathy interventions included in the Simulation Room are vulnerable patient groups: people from culturally and linguistically backgrounds, frail older people, larger people and those with a mental illness, cerebral palsy, or acquired brain injury. Research indicates that simulations specifically targeting empathy can promote understanding and change attitudes towards people from stigmatised groups (Batson et al., 2002). Importantly, we advocate that the enhanced levels of empathy that can result from point-of-view simulations may have a flow on effect and potentially improve the negative healthcare experiences and risk of adverse patient outcomes so often encountered by people from vulnerable groups.
The simulations we have included in the Simulation Room were developed through a process of co-design where the views and experiences of healthcare consumers were used to guide scenario development. This approach enhanced the authenticity of the simulations and ensures that they target key issues that are most important to patients.
Previous evaluations of the simulations attest to their effectiveness in enhancing empathy levels (Levett-Jones et al, 2017; Everson et al, 2018; Orr et al, 2013; Ward et al, 2018) and demonstrate a high level of learner satisfaction (Courtney-Pratt et al, 2015; Levett-Jones, et al, 2018; Kelly et al, 2016; Reid-Searl, Mainey, Bassett & Dwyer, 2018). The validated evaluation instruments that we used in these studies are included in the simulation toolkits and can be used with appropriate acknowledgement.
Bearman, M., Palermo, C., NutriDiet, L., Williams, B. (2015). Learning empathy through simulation. Simulation in Healthcare, 10, 308-319.
Bosse, H., Schultz, J., Nickel, M., Lutz, T., Möltner, A., Jünger, J., Huwendiek, S. & Nikendei, C. (2012). The effect of using standardized patients or peer role play on ratings of undergraduate communication training: A randomized controlled trial. Patient Education and Counseling 87, 300-306.
Bunn, W. & Terpstra, J. (2009). Cultivating empathy for the mentally ill using simulated auditory hallucinations. Academic Psychiatry 33, 457-460.
Courtney-Pratt, H., Levett-Jones, T., Lapkin, S., Pitt, V., Gilligan, C., Rossiter, R. Everson, N. & Jones, D. (2015). Development and psychometric testing of the Satisfaction with Cultural Simulation Experience Scale. Nurse Education in Practice, 15(6), 530-536.
Daeppen, J., Fortini, C., Bertholet, N., Bonvin, R., Berney, A., Michaud, P., Layat, C. & Gaume, J. (2012). Training medical students to conduct motivational interviewing: a randomized controlled trial. Patient Education and Counseling 87, 313-318.
Everson, N. Levett-Jones, T., Pitt, V., Lapkin, S., Van Der Riet, P., Rossiter, R. Jones, D., Gilligan, C. & Courtney-Pratt, H. (2018). Analysis of the Empathic Concern subscale of the Emotional Response Questionnaire in a study evaluating the impact of a 3D cultural simulation. International Journal of Nursing Education Studies, 15(1), 1-14.
Henry, B., Ozier, A. & Johnson, A. (2011). Empathetic responses and attitudes about older adults: How experience with the aging game measures up. Educational Gerontology, 37, 924-941.
Kelly, M., Berragan, E., Husebø, S. & Orr, F. (2016). Simulation in Nursing Education-International Perspectives and Contemporary Scope of Practice. Journal of Nursing Scholarship. 48(3), 312-321.
Lee, H. (1960). To Kill a Mockingbird. New York: Grand Central Publishing.
Levett-Jones, T., Lapkin, S., Govind, N., Pich, J., Hoffman, K., Jeong, S., Norton, C., Maclellan, L., Robinson-Reilly, M. & Everson, N. (2017). Measuring the impact of a point-of-view disability simulation on nursing students’ empathy using the comprehensive state empathy scale. Nurse Education Today. 57, 75-81
Levett-Jones, T. Lapkin, S., Govind, N., Pich, J., Hoffman, K., Jeong, S., Norton, C., Maclellan, L. & Robinson-Reilly, M. (2018). Exploring nursing students’ perspectives of a novel ‘point of view’ disability simulation. Clinical Simulation in Nursing.18, 28-37
Orr, F., Kellehear, K., Armari, E., Pearson, A. & Holmes, D. (2013). The distress of voice-hearing: The use of simulation for awareness, understanding and communication skill development in undergraduate nursing education. Nurse Education in Practice, 13(6), 529-535.
Reid-Searl, K., Mainey, L., Bassett, J. & Dwyer, T. (online 2018). Using simulation to prepare neophyte nursing students to deliver intimate patient care. Collegian.
Ward, A., Mandrusiak, A. & Levett-Jones, T. (2018). Cultural empathy in physiotherapy students: A pre-test post-test study utilising virtual simulation. Physiotherapy. 104, 453-461. DOI: https://doi.org/10.1016/j.physio.2018.07.011