Empathy of nursing students in a simulated clinical activity

Objective: To identify and evaluate the empathy of nursing students before and after a simulated clinical activity. Method: This is a quantitative and quasi-experimental study, carried out in the inland of the state of São Paulo. 107 nursing students participated in the study. A medium-fidelity clinical simulation scenario was built and validated. Empathy was evaluated through the Empathy Inventory before and after the simulated clinical activity. Results: There were positive changes after the simulated clinical activity in the cognitive components of empathy and there were no changes, in parts, in the affective component of empathy. Conclusion: The simulated clinical activity, well outlined in a validated clinical simulation scenario, was able to improve the cognitive component of empathy but was not susceptible to changes in the affective component of empathy, which transfigures into feelings of compassion and altruism. DESCRIPTORS: Empathy; Teaching; Education; Nursing; Humanization of Care. HOW TO REFERENCE THIS ARTICLE: Cotta Filho CK, Meska MHG, Machado GCC, Franzon JC, Mano LY, Mazzo A. Empathy of nursing students in a simulated clinical activity. Cogitare enferm. [Internet]. 2020 [access “insert day, monh and year”]; 25. Available from: http://dx.doi.org/10.5380/ce.v25i0.68142. 1Nurse. Master student in Pharmacology. University of São Paulo. Ribeirão Preto, SP, Brazil. 2Nurse. Master student in Nursing. University of São Paulo. Ribeirão Preto, SP, Brazil. 3Nurse. Nurse at the Clinics Hospital of the Ribeirão Preto Medical School. Ribeirão Preto, SP, Brazil. 4Nurse. Master student in Nursing. University of São Paulo. Ribeirão Preto, SP, Brazil. 5Computer Scientist. PhD student in Mathematics and Computer Science. University of São Paulo. São Carlos, SP, Brazil. 6Nurse. Full Nursing Professor. Professor at the University of São Paulo. Bauru, SP, Brazil. dx.doi.org/10.5380/ce.v25i0.68142 Cogitare enferm. 25: e68142, 2020 Cezar Kayzuka Cotta Filho1, Mateus Henrique Gonçalves Meska2, Giovanna Cristina Conti Machado3, Juliana Constantino Franzon4, Leandro Yukio Mano5, Alessandra Mazzo6 EMPATIA DE ESTUDANTES DE ENFERMAGEM EM ATIVIDADE CLÍNICA SIMULADA RESUMO Objetivo: identificar e avaliar a empatia de estudantes de enfermagem antes e após atividade clínica simulada. Método: trata-se de um estudo quantitativo e quase-experimental, realizado no interior do Estado de São Paulo. Fizeram parte do estudo 107 estudantes de graduação em enfermagem. Foi construído e validado um cenário de simulação clínica de média fidelidade. A empatia foi avaliada por meio do Inventário de Empatia antes e após a atividade clínica simulada. Resultados: houve mudanças positivas após a atividade clínica simulada nos componentes cognitivos da empatia e não houve mudanças, em partes, no componente afetivo da empatia. Conclusão: a atividade clínica simulada bem delineada em um cenário de simulação clínica validada foi capaz de melhorar o componente cognitivo da empatia, porém não foi passível de mudanças no componente afetivo da empatia, o qual transfigura em sentimentos de compaixão e altruísmo. DESCRITORES: Empatia; Ensino; Educação; Enfermagem; Humanização da Assistência. Cezar Kayzuka Cotta Filho | Mateus Henrique Gonçalves Meska | Giovanna Cristina Conti Machado | Juliana Constantino Franzon | Leandro Yukio Mano | Alessandra Mazzo ARTIGO ORIGINAL / ARTÍCULO ORIGINAL EMPATÍA DE ESTUDIANTES DE ENFERMERÍA EN ACTIVIDAD CLÍNICA SIMULADA RESUMEN: Objetivo: Identificar y evaluar la empatía de estudiantes de enfermería antes y después de actividad clínica simulada. Método: estudio cuantitativo e cuasi experimental, realizado en el interior del Estado de São Paulo. Participaron del estudio 107 estudiantes de grado de enfermería. Se construyó y validó un escenario de simulación clínica de fidelidad media. La empatía se evaluó utilizando el Inventario de Empatía antes y después de la actividad clínica simulada. Resultados: hubo cambios positivos después de la actividad clínica simulada en los componentes cognitivos de la empatía mientras que no los hubo en el componente afectivo de la empatía. Conclusión: la actividad clínica simulada bien diseñada en un escenario de simulación clínica validado pudo mejorar el componente cognitivo de la empatía, pero no estuvo sujeta a cambios en el componente afectivo de la empatía, lo que se transfigura en sentimientos de compasión y altruismo. DESCRIPTORES: Empatía; Enseñanza; Educación; Enfermería; Humanización de la Asistencia. dx.doi.org/10.5380/ce.v25i0.68142 Cogitare enferm. 25: e68142, 2020 Cogitare enferm. 25: e68142, 2020 Empathy of nursing students in a simulated clinical activity INTRODUCTION In the health service, the interaction between professionals and patients occurs routinely, and this is essential for care to be effective. One of the components that facilitate such an interpersonal relationship is empathy(1). Empathy is a social skill developed during childhood, but it can be learned during adulthood(2). The empathetic individual is one who is able to understand the feelings of others in a sensitive way, demonstrating their full understanding through their behavior. In the context of health education, this skill has been developed through strategies such as art teaching, reflexive writing, and clinical simulation(1,4-6). Empathy is divided into three components: cognitive – a phase in which the individual understands precisely the feelings and perspective of other people; affective – a period in which there is an interest in meeting the needs of others with compassion, sympathy, and concern, without necessarily living the experience of the other, but an understanding of what is felt by them; and behavioral – in which one demonstrates to the other a full understanding of their feeling and perspective(3). When the individuals are empathetic, it is easier for them to create quality affective bonds, they better develop interpersonal relationships and social coexistence through favorable communication, greater ability to solve problems, increased self-esteem and self-confidence, thus overcoming the feeling of inferiority and ability to listen, understand, and reduce emotional problems(7-10). Patients who receive empathetic care from a professional show greater satisfaction with the service, resulting in improved prognosis and greater adherence to the treatment(1,11). Health professionals with a higher level of empathy have been associated with lower levels of stress in the work environment, and less depression and burnout syndrome, and are less likely to perform acts of neglect in health care(11). In this context, aiming at the training and performance of more humanized health professionals, with greater relationship skills, assertiveness in the relationship processes with the patient and health team, it is essential to shape teaching strategies that increase their levels of empathy, since the level of empathy of the students has been declining throughout their training(11-13). Clinical simulation has been considered an inevitable and necessary teaching method in the training of health professionals and can be defined as the attempt to imitate a certain situation of the real scenario in an artificial context. Its purpose is to promote in the students the development of technical skills, clinical reasoning, decision making, and evaluation, among others. In addition, it provides a better understanding and control of the real situation through prior training in a totally safe and risk-free environment for both the patient and the apprentice(4,14). In view of this strategy, in the daily nursing practice, it is common to come across patients who require care in their physiological elimination needs, who require individualized care, considered a delicate and intimate situation for both patient and professional. When physiological elimination needs are altered, the individuals become fragile, vulnerable, and easily exposed and, at that moment, the ethical and empathetic work of the nurse is indispensable(15). In this context, this study aimed to identify and evaluate the empathy of the nursing students before and after a simulated clinical activity in a scenario that promotes nursing care in the physiological elimination needs.