Empathy is the foundation of caring in the nursing profession. It is critical to an effective patient-nurse relationship and impacts decision-making in nursing care. This study aimed to investigate the impact of virtual simulation on nursing students’ empathy and the relationships of empathy to their demographic characteristics. A randomized pretest and posttest control group design was employed in the study with 140 participants from twelve undergraduate nursing programs across Canada. A virtual simulation scenario was created by the author regarding a patient with substance overuse in an acute care setting. Standardized patients were employed to portray the virtual characters to enhance realism and immersive experience. The participants in the control group reviewed a text-based case study, which consisted of an identical storyline of the virtual simulation scenario, while those in the intervention group experienced the virtual simulation activity. The Kiersma-Chen Empathy Scale-Revised (KCES-R), Substance Abuse Attitude Survey (SAAS), and a demographic survey consisting of age, gender, personal, family, and learning experiences related to substance overuse, were used in the study. The results indicated empathy was significantly increased after the learning activities in both groups, but nonsignificantly different between the participants in the text-based case study and virtual simulation groups before and after the learning activities. Meanwhile, the participants’ attitudes toward substance overuse did not change significantly after their learning activities. All demographic characteristics were nonsignificantly correlated to the participants’ empathy as well. However, the participants’ empathy toward the patients with substance overuse was significantly associated with their attitude toward substance overuse. This study is one of the few studies that employed virtual simulation to promote nursing students’ empathy. Although the study did not demonstrate a significant difference between the text-based case study and virtual simulation groups after the learning activities, it supports that virtual simulation is effective for promoting empathy in nursing education as a text-based application. Future studies will be needed to explore different virtual simulation designs and to determine how individual characteristics influence the cognitive process of perspective-taking in promoting empathy.

The purpose of this study was to examine the effects of the Skillstreaming the Adolescent social skills training program on sixth grade students' social skills as reported by themselves, their teachers, and their parents. The study was conducted in two phases. Participants in Phase I were 24 sixth grade boys and 25 sixth grade girls selected from a Midwestern, small suburban elementary school. Experimental Group 1 consisted of 24 students and Control Group I consisted of 25 students. The mean age of the students was 11.7 years. Participants in Phase II were 28 sixth grade boys and 21 sixth grade girls. Experimental Group 2 (n=16) and Experimental Group 3 (n=16) were combined for the training intervention. Control Group 2 consisted of 17 students. The mean age of these students was 11.6 years. Pretest and posttest assessments of students' social skills were measured using the Social Skills Rating System-Parent, Teacher, and Student forms (Gresham & Elliot, 1990). Data were analyzed for both phases using repeated Measures of Multivariate Analysis of Variance. In Phase I no significant interaction between time of testing, raters, and group were found. However, differences were found between the experimental and control groups regardless of time, and between time (pre and post tests) regardless of group, primarily due to teacher ratings. In Phase II there was a significant interaction between time of testing, raters, and group. The control group scored higher than the experimental group on students' social skills ratings. Based on univariate tests, the control group's significantly higher ratings were the result of teacher ratings. This study did not find support for the overall efficacy of the Skillstreamins, the Adolescent training program on improving students' social skills as measured by the SSRS-parent, teacher, and student forms. Results and implications of these findings are discussed as they relate to previous research and future directions for study. It is suggested a follow-up measure when students transition to junior high school may provide evidence of long-term effects of social skills programs. An investigation of teachers' expectations may also provide a greater understanding of the impact of training programs. / Department of Educational Psychology