Nicki Goedecke and Dawn ...

    One of the most important soft skills needed for future healthcare professionals, empathy is often considered the ability to put oneself in another person’s shoes and respectfully seek to understand their perspective. It involves active listening, respect for patients, and a desire to work with them to achieve their health goals, rather than dismissing their non-expert opinions.1

    Cognitive empathy, concerned with one’s ability to ascertain and appreciate what another person is feeling, is identified by researchers as a type of skill that can be learned and improved. This is excellent news for healthcare educators looking to instill their students with the knowledge and experience of competent, thoughtful, and understanding practitioners.

    Why Educate on Empathy

    Employing empathy-building exercises in healthcare education can be a challenge, but it is a vital and worthwhile undertaking. It is not something students can get from textbooks or mere classroom instruction.

    Bhavana Aitha, a nursing student at the University of Delaware, encourages healthcare students to find ways to participate in simulated scenarios to build empathy.

    “We must remain in tune with human connection in order to form lasting and trusting relationships with our patients and with fellow health care team members,” Aitha writes. “Only then will we be able to provide the highest quality care for our patients, who deserve that, and so much more.”2

    Further, as Jill Litman writes in Berkeley Public Health’s The Public Health Advocate,

    “… there is a positive association between increased empathy in a clinical setting and a number of advantages, including diagnostic accuracy, psychological and pharmacological interventions in psychiatry, and ‘patient enablement’ or the extent to which a patient is capable of understanding and coping with his or her health issues…When empathy is present in patient-doctor relationships, better health outcomes have been reported.” 3, 4, 5

    If we acknowledge, then, that empathy is a desirable trait and skill in healthcare practitioners, the question then becomes how to incorporate empathy training into healthcare education – and how to measure that training’s effectiveness.

    Practical Exercise: Minute Conversations

    One key to creating empathy is the art of active listening. An exercise out of Indiana University of Pennsylvania (IUP) guides participants through three rounds of one-minute conversations. Rachel DeSoto-Jackson adapted it for her course The Performance of Caring, part of the Simulated Patient and Applied Theater Ensemble.6 Although the original exercise asks students to pair up while circulating in a classroom, with remote learning, the instructor may have to pair up students by drawing names.

    1. Participants pair up for this exercise. Students walk around the room, greeting each other as they circulate.

    2. Instructor calls out “STOP.” Participants form a pair with the person closest to them. Teams of three (3) can be formed as necessary.

    3. Instructors provide a prompted question. Taking turns, participants talk for one minute, with their partner listening, but not reacting verbally or non-verbally. At the end of the minute, timed by the instructor, the roles switch.

    4. Prompted questions:

    • Describe a time when you achieved a goal.
    • Describe a time when you felt powerless.
    • Describe a time when you felt cared for.

    5. Participants then describe the feelings they had as they spoke and as they listened.

    The need for compassionate, competent healthcare providers is ever-growing. As more technologies emerge, providing the opportunity to create realistic, lifelike experiences during healthcare simulation, educators must remember to incorporate empathy into their learning interventions.

    By advancing humanism in the classroom, future healthcare professionals will carry these practices into the clinic, creating a “respectful and compassionate relationship between physicians, members of the healthcare team, and their patients. 7 (11)

    This is an excerpt from Building Empathy in Healthcare Students Using Simulation, a white paper created by Pocket Nurse® in collaboration with Nasco. Download the complete white paper here.


    1. Goedecke, N. M. (2019, July 17). “4 Methods for Empathy Building in Pharmacy Simulation,” SimTalk Blog. blog/4-methods-for-empathy-building-in-pharmacy-simulation

    2. Aitha, B., (2018 September). “The Importance of Empathy in Health Care: Part 1 of the Series From Nursing Student to Patient and Back Again.” NLN Nursing Edge.

    3. Litman, J. (2018, May 16). Empathy in Medical Education: Can Kindness Be Taught?

    4. Kelley JM, Kraft-Todd G, Schapira L, Kossowsky J, Riess H (2014) The Influence of the Patient-Clinician Relationship on Healthcare Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLOS ONE 9(4): e94207.

    5. Spencer, J. (2004), Decline in empathy in medical education: how can we stop the rot?. Medical Education, 38: 916-918. https://

    6. “Simulated Patient Applied Theater,” Indiana University of Pennsylvania.

    7. Mieres, J. and Wright, M. (2019 January).“Commentary: For more successful health policy and outcomes, think like a human,” Modern Healthcare.