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Reframing the Kirkpatrick model for evaluating humanistic care training in nursing: a context-sensitive integrative
Wan-Lu Liu1, Lei Chen2, Lin Zhang3
1Department of Nursing Care, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China.
Frontiers in Public Health
|April 13, 2026
Summary
The Kirkpatrick model (KM) needs adaptation for evaluating humanistic nursing care. A flexible, context-sensitive approach is crucial for assessing relational skills in complex healthcare settings.
Area of Science:
- Health Professions Education
- Nursing Education Research
- Educational Evaluation Theory
Background:
- The Kirkpatrick model (KM) is a widely adopted framework for evaluating training programs.
- Its linear application may not adequately capture the nuances of relational competencies in nursing.
- Complex clinical environments present challenges for traditional evaluation methods.
Purpose of the Study:
- To critically examine the application of the Kirkpatrick model (KM) in humanistic care training for nurses.
- To propose a reconceptualization of KM as a context-sensitive, probabilistic framework.
- To offer methodological guidance for evaluating nursing education in real-world settings.
Main Methods:
- Critical analysis of the Kirkpatrick model's four levels (reaction, learning, behavior, results).
- Review of contemporary educational evaluation theory and nursing education research.
- Development of minimum validity conditions and an operationalized evaluation matrix.
- Discussion of technology-enhanced evaluation modalities (simulation, virtual reality).
Main Results:
- Conventional linear KM is insufficient for assessing relational competencies in nursing.
- KM should be viewed as context-sensitive and probabilistic, not deterministic.
- Methodological challenges exist at all KM levels, particularly in behavioral transfer and self-reported data.
- Proposed validity conditions and an evaluation matrix enhance rigor.
Conclusions:
- Reconceptualizing the Kirkpatrick model is essential for effective evaluation of humanistic nursing care.
- An integrative health sciences lens and technology-enhanced tools can strengthen evaluation strategies.
- Actionable guidance is provided for designing and interpreting nursing education evaluations.
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