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Colette Daiute

Committee Members

Kay Deaux

Karina Davidson

Barbara Katz Rothman

Kathryn Richardson

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The goal of this exploratory study was to teach nursing students to perceive empathy as a dialogic process versus as a personal characteristic through narrative reflection. This required the development of a dialogic empathy model for nursing education; that is, a model that presents empathy as a reciprocal process shared by the nurse and client within their interactions. Given the increasing cultural diversity between providers and clients in stressful medical situations, awareness of the interaction of the characteristics of oneself and another (i.e., dialogism) could potentially enhance both the efficacy and experience of care.

This study included (a) narrative reflection of nurse-client interactions from various perspectives (based on Discourse Theory) and (b) pre/posttest assessments in a randomized design. I collected data from 44 participants in a first semester clinical nursing theory undergraduate course in Fall 2003.

First, can dialogic empathy be assessed? The narratives written by the participants in the experimental condition provided data with which to define and examine the proposed model of dialogic empathy. A repeated measures analysis of narrative content revealed that dialogic empathy (i.e., reciprocal awareness of one's own and another's perspectives), differed by context: More dialogic empathy was evident in narratives about the more vulnerable populations.

Second, can nursing students learn to perceive empathy as a dialogic process by writing narrative reflections? The pre/posttest randomized design revealed between-group differences. The three primary outcomes were the posttest minus pretest scores for the level of dialogism in the Ideal Nurse responses, and two subscale scores for the dialogic-type subscales of the quantitative measures. The secondary outcome was the thematic responses to the posttest What is Empathy? task. Though statistical power was restricted by the small sample size, all assessments suggested that although empathy was perceived as a personal characteristic, it was more likely to be perceived as an intention or process by those in the experimental condition. Future research is required to explore if a dialogic view of empathy, one that values nurses' needs and interests, as well as those of their clients, increases nurse retention in the health care profession.


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