Evaluation of Simulation Learning to Promote Empathy in Nursing Students Across the Curriculum: A Mixed Method Study.

Empathy is a foundational nursing principle necessary for caring. Limited data exist on the effective methods for teaching empathy. Six simulation activities were conducted (stool/ostomy, stroke, hearing voices, pregnancy, poverty, and bedpan/adult diaper) with nursing students across multiple education levels, yielding 138 simulations. Quantitative analyses compared the Toronto Empathy Questionnaire scores pre- and postsimulation. Krippendorff's content analysis identified 3–11.2 empathic statements per reflective journal after four simulations. Colaizzi's phenomenological analysis resulted in seven themes that describe the students' experience of gaining empathy. The results support simulation activities as an effective educational pedagogy in nursing curricula to support attainment of empathic behaviors.