ArticleBMC nursing2025
Impact of 3D simulation on cultural empathy education of nursing students: a quantitative study.
Article in BMC nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDeveloping cultural empathy is essential for safe, person-centred nursing care. Compared with lectures or workshops, simulation offers active perspective-taking and emotional engagement. We implemented a screen-based stereoscopic 3D simulation (not head-mounted VR) to immerse students in culturally complex encounters and evaluated immediate empathy gains and learner satisfaction.
objectivesTo assess pre–post changes in state empathy following a 3D cultural simulation and to examine satisfaction and its demographic correlates.
methodsA single-group pre–post quasi-experimental study was conducted with first-year undergraduate nursing and midwifery students at an Australian metropolitan university (N = 349). All instruction was delivered in English, and participants met university English-language entry requirements. Primary outcome was state empathy (Comprehensive State Empathy Scale, CSES; six subscales). Satisfaction with the cultural simulation (SCSES) was the secondary outcome. Paired t-tests (pre vs. post) estimated mean change and effect sizes; chi-square tests examined associations between demographics and satisfaction.
resultsTotal CSES increased significantly from pre- to post-simulation with a medium effect size (Cohen’s d ≈ 0.41; p < 0.001). All six empathy subscales improved (all p < 0.001), with the largest gains observed in Distress and Shared Affect, consistent with stronger affective engagement during immersive scenarios. Students reported high satisfaction across SCSES domains. Age and gender were significantly associated with satisfaction (p = 0.001), whereas cultural background variables were not.
conclusionsA screen-based 3D cultural simulation produced meaningful, immediate improvements in state empathy and high learner satisfaction, supporting simulation—over didactic formats—as a pedagogically potent approach for empathy development. While 3D shares immersive affordances with VR (presence, first-person perspective), it is scalable without head-mounted displays. Long-term durability and transfer to clinical behaviour were not assessed and warrant longitudinal and comparative (3D vs. HMD-VR; simulation vs. workshops) trials. CLINICAL TRIAL NUMBER: Not applicable.
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