Elsevier

Nurse Education Today

Volume 35, Issue 1, January 2015, Pages 38-43
Nurse Education Today

Impact of the Geriatric Medication Game® on nursing students' empathy and attitudes toward older adults

https://doi.org/10.1016/j.nedt.2014.05.005Get rights and content

Summary

Background

Nurses should be well-prepared to improve and address health-related needs of older adults, but students may have difficulty understanding and empathizing, as they may not yet have personally experienced aging-related challenges. Simulation games can be used to help students understand the experiences of others, but limited information is available on the impact of simulation experiences on student empathy.

Objective

The objective of this study was to examine the impact of participation in an aging simulation game on nursing students' empathy and attitudes toward older adults as well as their understanding of patients' experiences in the healthcare system.

Design

This study used a quasi-experimental, pretest-posttest design.

Setting

A school of nursing in the Midwestern United States.

Participants

The convenience sample included 58 sophomore-level baccalaureate nursing students.

Methods

Students played the role of an older adult during a 3-hour laboratory aging simulation game, the Geriatric Medication Game® (GMG). Students completed the (1) Kiersma–Chen Empathy Scale (KCES, 15 items, 7-point Likert-type), (2) Jefferson Scale of Empathy—Health Professions Students (JSE-HPS, 20 items, 7-point Likert-type), and (3) Aging Simulation Experience Survey (13 items, 7-point Likert-type) pre- and post-game to assess study objectives. Descriptive statistics and paired t-tests were performed in SPSS v.21.0, as the data were normally distributed.

Results

Students' empathy (N = 58) toward older adults significantly improved overall (KCES p = 0.015, JSE-HPS p < 0.001). Improvements also were seen on seven out of 13 questions related to attitudes and healthcare understanding (p < 0.05). In the post-test, students agreed that they experienced frustration and impatience during the GMG.

Conclusions

Students may not be aware of older adults' feelings and experiences prior to experiencing aging-related changes themselves. Simulation activities, such as the GMG, can be a useful mechanism for addressing empathy and caring during student education.

Introduction

The proportion of older adults within the United States is increasing, and by 2025, nearly 18% of the United States population will be at least 65 or older (U.S. Census Bureau, 2012). Prevalence of chronic disease also is increasing among older adults (Pearson et al., 2012). Nurses need to be well-prepared to address the needs of the growing population of older adults. However, students and novice nurses may have difficulties in understanding and empathizing with older adults, as they may not have personally experienced aging-related challenges, such as disability and disease.

Empathy and understanding are critical skills, as health provider attitudes have been found to influence the quality of care provided (Courtney et al., 2000, Eymard and Douglas, 2012).The National Institute of Nursing Research and the Institute of Medicine advocate that the quality of care provided to older adults needs to be improved (Institute of Medicine, 2008, National Institute of Nursing Research, 2006). By incorporating activities within the undergraduate nursing curriculum to address attitudes and empathy, future generations of nurses may demonstrate positive attitudes and empathy, thus improving the quality of care provided. Furthermore, in baccalaureate nursing education, the American Association of Colleges of Nursing (AACN) emphasizes the importance of empathy and caring as part of the professional role and integral to all healthcare interactions (American Association of Colleges of Nursing, 2008).

In order to foster patient-centered care and meet accreditation standards, it is important to incorporate curricular activities that increase nursing student empathy and attitudes towards a variety of patient groups. To address this, a simulation-based educational activity was incorporated into a clinical course.

Section snippets

Background

Empathy consists of two distinct aspects: the ability to comprehend and see the world from others' perspectives (cognitive empathy) and to connect to others' experiences or feelings (affective empathy) (Davis, 1994). Decades ago, nurses often had negative views of aging and were not empathetic toward older adults (Bonstelle and Govoni, 1984, Marte, 1988, Slevin, 1991). Since then, incorporating geriatric-specific education within the undergraduate nursing curriculum has improved some attitudes (

Methods

Institutional review board approval (exempt status) was obtained prior to data collection.

Demographic Characteristics and Overall Experience

The nursing students (N = 58) were mostly female (87.9%) and between the ages of 19 and 21 (94.8%). Most had close relationships or prior work experience with older adults (Table 1). At least 75% of students experienced annoyance, frustration, and impatience while completing the GMG, particularly when they lost an ability, were unable to complete a task easily, or when they had to wait in line. Students believed that their attitude toward older adults changed as a result of completing the GMG and

Discussion

Incorporating the Geriatric Medication Game® (GMG) into a nursing course resulted in significant improvement in student empathy toward older adults and greater understanding of the healthcare system and older adult experiences. Incorporating games into the curriculum can be a useful educational strategy and can encourage learning in a low-risk environment (Schmall et al., 2008). While the GMG has not been previously utilized with nursing students, other aging simulation games or experiences,

Conclusions

Development of curricular strategies, such as incorporation of the Geriatric Medication Game®, can emphasize the importance of empathy and caring to students. Students may not be aware of older adults' feelings and experiences prior to experiencing aging-related changes themselves, and simulation activities can be a useful mechanism to allow students to “walk in the shoes” of an older patient. Instruments such as the JSE-HPS, the KCES, and the ASES are tools that can be utilized to inform and

Acknowledgments

Support for this project was provided by the Purdue University Learning Outcomes Assessment Grant and the Purdue University College of Pharmacy. Support for Aleda Chen while a graduate student was provided by the National Institute on Aging (T32AG025671) and the Purdue University Center on Aging and the Life Course as well as from the American Foundation for Pharmaceutical Excellence.

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