Learning and unlearning dignity in care: Experiential and experimental educational approaches

Abstract

AcknowledgementsWe are grateful to Scottish Crucible for the opportunity to establish our collaboration and for funding this research. We also thank our students who participated enthusiastically and gave of their time generously. REVISED TITLE:Learning and unlearning dignity in care: experiential and experimental educational approaches ABSTRACTGuarding against loss of human dignity is fundamental to nursing practice. It is assumed in the existing literature that 'dignity' as a concept and 'dignity in care' as a practice in amenable to education. Building on this assumption, a range of experiential and experimental educational approaches have been used to enhance students' understanding of dignity. However, little is known about student nurses' views on whether dignity is amenable to education and, if so, which educational approaches would be welcomed. This mixed-methods study used an online questionnaire survey and focus groups to address these questions. Student nurses in Scotland completed online questionnaires (n=111) and participated in focus groups (n=35). Students concluded that education has transformative potential to encourage learning around the concept of dignity and practice of dignity in care but also believed that dignity could be unlearned through repeated negative practice exposures. Experiential and experimental educational approaches were welcomed by student nurses, including patient testimony, role-play, simulation, and empathy exercises to step into the lives of others. Nurse educators should further integrate experiential and experimental educational approaches into undergraduate and postgraduate nursing curricula to guard against the loss of learning around dignity students believed occurred over time.

Empathy in Nursing Students: A Scoping Review

“…This study describes three educational interventions: empathy-specific training, integrated curricula, and practice-oriented education. With 26 studies in support, most educational interventions for promoting empathy involved empathy-specific training, for example, communication skills training, intercultural nursing course, digital storytelling, narrative photography, and mindfulness-based empathy training (Ahmad et al, 2020; Arda Sürücü et al, 2021; Bas-Sarmiento et al, 2017, 2019; Can Gür & Yilmaz, 2020; Cannity et al, 2021; Chen et al, 2015; Çingöl et al, 2021; Dincer & Inangil, 2022; Ding et al, 2020; Eren & Gürhan, 2021; Fleming et al, 2015; Gholamzadeh et al, 2018; Goh et al, 2020; Hovland et al, 2021; Kimzey et al, 2019; Kyle et al, 2017; Lee et al, 2018; Leyva-Moral et al, 2021; Mikkonen et al, 2015; Petrucci et al, 2016; Petty et al, 2020; Suh et al, 2021; van Vliet et al, 2017; Yang et al, 2020; Yu et al, 2019). According to two studies (Celale Tangul et al, 2018; Heidke et al, 2018), integrated empathy curricula can also be considered in nursing education because the development of communication skills was improved more by integrated curricula than by conventional curricula.…”

Discovering dignity through experience: How nursing students discover the expression of dignity

“…Both the culture in the clinical field and the learning environment are of great importance for how students discover dignity, as well as which role models students acquire. 17,18,22,24 Clinical supervisors have a key function in creating a learning environment that reflects professional nursing values. The students described some clinical supervisors and nursing teachers that they wanted to resemble, that they respected and trusted.…”

“…7,11,12 Research has been carried out on how nursing students acquire values in general and dignity in particular, but several of these studies are intended to operationalize how dignity can be learned through different techniques and learning methods. 10,17,18 Other research indicates that dignity is an abstract inherent phenomenon in humans and something that is integrated through processes of socialization. 8 However, others argue that the education must facilitate it so that dignity can be discovered through experiences.…”

“…9,[19][20][21] Furthermore, research refers to the importance of lived life experience, learning culture and role models. 17,18,20,[22][23][24] There is a need for research that sheds light on how ethical values, such as dignity, are promoted in students. 20,25,26 Nursing students are underrepresented in research in this field.…”

Dignity in nursing: A synthesis review of concept analysis studies

“…Some authors describe those as communication skills 31,33 and knowledge about professional ethics in care 19 as essential topics to facilitate the expression of dignity. Education and ethical competence [42][43][44][45] translate self and others' empowerment, allowing attributes combination to be expressed in autonomy, respect, and in the consequences of preserved dignity. These antecedents identified by Mairis 31 are particularly important in regards to nursing practice because they are the foundations on where future nurses will develop their core values on nurse's ethics of care.…”